Prepared by: Highway Safety Research Center University of North Carolina November 2005

1. Basics of Child Passenger Safetyin North Carolina Prepared by: Highway Safety Research Center University of North Carolina November 2005

2. Basics of Child Passenger Safety The Need for Child Restraints and NC Occupant Restraint Laws

3. The Need for Child Restraints • Children are not miniature adults • Need special restraints • Infant's head larger and heavier - Legs are shorter • Newborn's shoulders are narrow and flexible • Child's pelvis is small, rounded and not fully developed until puberty.

4. The Need for Child Restraints • Child restraints (CRs) work with belts to • Prevent ejection • Distribute and load crash forces to the strongest parts of the body. • CR must be properly used to be able to do this • Occupant restraint systems can not promise complete crash protection, but • CRs about 70% effective in reducing fatalities and serious injuries • Lap & shoulder belts plus frontal air bags about 50 - 60% effective

5. NC Has 3 Occupant Restraint Laws • CPS Law • Seat Belt Law • Children in Back of Pickup Trucks

6. NC CPS Law • G.S. 20-137.1 - Effective January 1, 2005 • Requirements • Covers children < age 16 in any seating position • Properly used CR/Booster required if less than age 8 AND less than 80 pounds • Properly used seat belt allowed at age 8 OR 80 lbs., whichever comes first • If no lap and shoulder belt is available for a booster, a child weighing at least 40 pounds may be restrained by a properly fitted lap belt only.

7. NC CPS Law • Requirements (continued) • Must be in rear seat if • Child is less than age 5 and less than 40 lbs. • Vehicle has active passenger side front air bag • Vehicle has a rear seat • Front allowed if the CR is air bag compatible

8. NC CPS Law • Exemptions • Ambulances & other emergency vehicles • Tending to personal needs • More kids than available belts • Vehicles not required to have belts • Were included in earliest version of the law • Helped get a law • Not considered to be safe or recommended practices

9. NC CPS Law • Penalties • Driver is responsible (even if not parent) • Maximum $25 fine • Full court costs (~$110) • 2 driver license points • No insurance points • Charges to be dropped if • Child < 8 and < 80 lbs. and • CR has been acquired for vehicle child is routinely transported in

10. NC CPS Law • No organizations are exempt from the NC CPS Law, only types of vehicles • Includes public and private schools, child care centers, churches, camps. etc • If vehicle is covered • CPS law applies • May be subject to additional regulations • If vehicle is exempt • NC CPS law does not apply • May be subject to additional regulations

11. NC Seat Belt Law • G.S. 20-135.2A • Requirements • Covers driver and front passengers older than age 15 (16+) • Properly used seat belt • Passenger motor vehicle in forward motion on street or highway

12. NC Seat Belt Law • Exemptions (generally not considered to be safe) • Medical, physical, mental conditions • Rural letter newspaper carriers • “Door to door” deliveries • Commercial/farm plates when being used for business • Vehicles not required to have belts • Penalties • $25.00 fine • $75.00 court costs (not subject to full cost of court) • No driver's license points • No insurance points

13. NC Children in PickupTrucks Law • G.S. 20-135.2B • Requirements • Covers children less than age 12 • Prohibited from riding in an open bed or open cargo area without permanent overhead restraining construction • No definition for “permanent overhead restraining construction”

14. NC Children in PickupTrucks Law • Exemptions (generally not considered to be safe) • Adult present and supervising the child • Child restrained by a seat belt • An emergency situation exists • In a parade pursuant to a valid permit • Agricultural enterprise • The vehicle is being operated in a county that has no incorporated area with a population in excess of 3,500

15. Camden Currituck Alleghany Northampton Gates Warren Ashe Caswell Perquimans Yadkin Bertie Avery Mitchell Franklin Yancey Alexander Tyrrell Madison Swain Hyde Greene Graham Jackson Polk Montgomery Cherokee Macon Pamlico Clay Jones Duplin Pender NC Children in Pickup Trucks Law : Exempt Counties Alexander, Alleghany, Ashe, Avery, Bertie, Camden, Caswell, Cherokee, Clay, Currituck, Duplin, Franklin, Gates, Graham, Green, Hyde, Jackson, Jones, Macon, Madison, Mitchell, Montgomery, Northhampton, Pamlico, Pender, Perquimans, Polk, Swain, Tyrrell, Warren, Yadkin, and Yancey Exempt Counties

16. NC Children in PickupTrucks Law • Penalties: • Maximum $25 fine • No court costs • No license points • No insurance points

17. Legal vs Recommended • Legal • Sets minimum standards • Laws are based mostly on age • Not required that all occupants be buckled up at all times in all positions • Recommended • Provides maximum protection • Best restraints to use also based on weight and physical development • EVERYONE should be properly restrained in all seating positions at all times

18. Basics of Child Passenger Safety HOW RESTRAINTS PROTECT OCCUPANTS IN CRASHES

19. What Happens in a Crash:Basics of Crash Dynamics • Dealing with laws of physics and motion: Object in motion will remain in motion... • Occupant moves toward point of impact until stopped by another object • Could be protective system (safety belts or child restraint), or • Could be hostile object Courtesy Insurance Institute For Highway Safety

20. Basics of Crash Dynamics • Weight times speed is an approximation of impact force

21. 1st 2nd 3rd Three Collisions In A Crash 1. Vehicle collision 2. Human collision 3. Internal collision

22. Five Ways Restraints Reduce Injury 1. Prevent ejection - If ejected: • 4 times more likely to be killed • 14 times as likely to sustain cervical spine injury 2. Load forces on strongest parts of the body • Older child or adult = Hips and shoulders • Infant and young child = Hips, shoulders and back 3. Spread forces over wide area • Belts/Harnesses = Over shoulders, chest & hips • Rear-facing CR = Over back, neck and head

23. Five Ways Restraints Reduce Injury 4. Allow the body to slow down gradually • Vehicles crush in a controlled manner • Can take advantage of vehicle ride down only if a "part" of the vehicle via safety belt or CR 5. Protect the head, neck, and spine • Shoulder belt/CR harness keeps head/upper body away from hostile surfaces of the vehicle • Rear facing CR supports the head and neck

24. Three-Part Process for Correct Use Essential for Maximum Protection • Restraint selection - Type of restraint, child restraint (CR), booster seat or seat belt, used must be appropriate for the age and size of the child 2) Securing the child in the restraint - The child must be correctly and snugly secured within the restraint itself 3) Installing the CR in vehicle – CR must be correctly and snugly secured in the vehicle by a tight and locked seat belt

25. Basics of Child Passenger Safety Choosing The "Best" Child Restraint

26. "What is the best car seat for my child?" • Common question, but no simple answer

27. NHTSA’s 4 Steps for Kids • Infants: Rear-facing • Toddlers: Forward-Facing with Harness • Boosters • Safety Belts

28. There Is No "Best” Car Seat For A Child • “Best” CR • Fits the child • Fits the vehicle(s) • Will be used correctly every ride • Least expensive meets same standards as most expensive

29. Rear-facing Only Rear-facing Convertible Rear Facing Restraints • Rear-facing Only • Most convenient • Fits small infants well • Rear-facing convertible • Can be used RF longer • Rear-facing CR until at least age one and at least 20 pounds. • Development of neck bones and ligaments • Rear-facing best for any body of any size • AAP recommendation

30. Front-facing Convertible Front-facing Only Front Facing Restraints • Front-facing convertible • At least 1 year old AND at least 20 pounds • Until harness outgrown – most at 40 lbs • Front-facing only CR with harness • Can Not be used for child less than 1 year old or less than 20 pounds • Until harness outgrown – most at 40 lbs • Some can be used as a booster >40 pounds

31. Front Facing Only - Integrated • Child restraints built into a vehicle seat • Some convert to a belt-positioning booster • Some have 5-point harness up to 40-60 pounds

32. Front Facing Only - Harness/Vest • E-Z-On Products • Many different styles and sizes • OK for lap belt only position for child > 40 lbs • Require top tethers • Travel vests • For children 25-40 lbs • Rigid back • No tether E-Z-On Y Harness Cosco Travel Vest

33. Incorrect Belt Fit Correct Belt Fit with Belt Positioning Booster Front Facing Only – Booster Seats • When harness is outgrown (usually about 40 lbs.) • Until both the lap and shoulder belts fit correctly • High back booster • Added whiplash protection • Backless booster • Light weight, easy to store • Generally less expensive

34. Safety Belts – Do Not Use Until: • Child can sit all the way back in seat • Child's knees bend comfortably over edge of seat • Shoulder belt crosses shoulder between neck and arm • Lap belt touches thighs • Child will stay seated like this for whole trip

35. NO! NO! Safety Belts – Common Misuse • Never tuck the shoulder belt under the arm or behind the back • Illegal • DANGEROUS!

36. NO! Safety Belts – Aftermarket Accessories • NO current federal standard for testing or regulation • Provides illusion of added safety • May move belt too high on abdomen

37. Safety Belts – Primary Risks of Lap Belts • Does not restrain the upper body • Impact with vehicle interior likely • Can "submarine" under belt if too loose • Belt-induced injuries – “Seat belt syndrome” • Injuries to the lower spine and organs such as spleen, liver and intestines • Results from belt too high or too loose 3 year old in a 30 MPH frontal crash test

38. Seat Belt Syndrome • Spinal cord or soft tissue damage due to • Improper placement of lap belt over the abdomen • Lap belt that rides up onto abdomen

39. Special Needs Restraints • Use conventional restraints when possible • Behavioral, medical or positioning needs may make specialized restraints necessary • Low birth weight most common “special need”

40. Summary of Restraint Selection Recommendations • Rear-facing (RF) • Until at least 1 year of age and at least 20 lbs. • RF convertible needed for most Infants • AAP recommends rear facing until maximum allowed RF weight for convertible is reached • Front-facing (FF) • Children over age 1 and at least 20 lbs. • In a FF convertible or other full harness type child restraint until the harness is outgrown

41. Summary of Restraint Selection Recommendations • Belt-positioning booster seat • After full harness child restraint is outgrown • Use booster until • Safety belt fits correctly and • Child is mature enough • Safety belt fits correctly when: • Child's bottom is against the back of the seat, • Knees bend at the edge of the seat cushion, • Lap belt fits low and tight across the upper thighs • Shoulder belt crosses the collar bone and chest

42. Basics of Child Passenger Safety HARNESSING CHILDREN CORRECTLY IN CHILD RESTRAINTS

43. Harnessing Children Correctly In Child Restraints • Function of Harness • Reduces ejection • Reduces contact with vehicle & other occupants • Distributes forces over widest area of body • Loads forces on strongest parts

44. Types of Harnesses • Three-point Harness • Five-point harness • Harness-Shield Combination • T-shield • Tray-shield • Shield Only

45. How Tight Is Tight Enough? • No slack • Pinch test • Not so tight as to press into the child's body • Retainer clips • Keeps the straps on the child's shoulders • Not required on all CRs • If required with CR, position about armpit level

46. Rear-Facing Infant And Convertible CRs • In general: Slot at or below the shoulders - or in the lowest slot • If needed: • Crotch roll • Rolled around head and/or sides

47. Rear-Facing Infant And Convertible CRs • Recline angle • Upright enough for crash protection but not so upright that the child's head falls forward toward the chest • Ranges from 30 - 45 degrees • Older children better able to tolerate more upright

48. Securing the Harness for Forward-Facing Convertibles • Straps threaded as specified by manufacturer • Upper slots for most models • Lower slots only if allowed by manufacturer • Retainer clip about armpit level if needed • Crotch strap • Refer to instructions • Adjust for proper positioning

49. Securing the Harness for Forward-Facing Only CRs • Straps threaded as specified by manufacturer - at or above shoulders for most models • Retainer clip about armpit level if needed • Crotch strap • Refer to instructions • Adjust for proper positioning

50. Basics of Child Passenger Safety INSTALLATION OF CHILD RESTRAINTS IN VEHICLES