Ejections of young children in motor vehicle crashes.
OBJECTIVE
The purpose of this study was to report the incidence of ejection from the vehicle among children involved in motor vehicle crashes, and to describe a novel mode of ejection from child safety seats.


METHODS
The U.S. National Automotive Sampling System General Estimates System and the Fatality Analysis Reporting System databases from 1995 through 1999 were analyzed. A prospective two-center study of children involved in severe car crashes in Canada was performed.


RESULTS
Only 0.2% of 5.5 million children involved in crashes experienced ejection, but 1924 (29%) of 6570 child fatalities involved ejections. Only 2.2% of children experienced rollover crashes, but these contributed 1832 (28%) of 6570 child passenger fatalities. Among 56 crashes, 5 restrained young children were ejected, 4 in rollover crashes. Ejection of a toddler through the shoulder straps of a forward-facing child safety seat was the mechanism of ejection in three of the five cases.


CONCLUSIONS
Ejection from the vehicle is common (29%) among fatally injured children. Shoulder straps alone (as found in T-shield or overhead shield child seats) may not prevent the ejection of toddlers from child safety seats during rollovers.
Howard
Andrew
A
Hospital for Sick Children, Toronto, Ontario, Ottawa, Canada. andrew.howard@sickkids.ca
McKeag
Ali Moses
AM
Rothman
Linda
L
Comeau
Jean-Louis
JL
Monk
Brian
B
German
Alan
A
D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D009864:Ontario / Q000453:epidemiology; D011446:Prospective Studies; D011482:Protective Devices; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*