title: Airbag deployment and improperly restrained children: a lethal combination.
abstract: BACKGROUND
  Airbag deployment is an acknowledged mechanism of serious trauma in children involved in motor vehicle crashes. From a review of national databases, we determined the number and types of fatal and nonfatal injuries to children caused by airbag deployment and child restraint system use. We also reviewed the relevant literature and provide information useful for caregivers and health care professionals in hopes of reducing future injuries.
  
  
  METHODS
  We retrospectively reviewed 263 reported cases in which airbag deployment caused fatal or nonfatal injuries in children from reports released by the National Highway and Transportation Safety Administration and the National Pediatric Trauma Registry. Data were collected from January 1993 to December 2002 and imported into a database program for analysis.
  
  
  RESULTS
  Of the 263 pediatric injuries caused by airbag deployment, 159 were fatal, and 104 were nonfatal. The peak incidence occurred in 1998, when 58 children were reported injured. Head injuries were most frequent, involving 170 children (64.6%), followed by spinal injuries, involving 100 children (38.0%). For children in their first year of life, head injuries were the sole mechanism of fatality. Of all children studied, only six (2.3%) were properly restrained.
  
  
  CONCLUSIONS
  Airbag deployment in motor vehicle crashes is a well-recognized mechanism of morbidity and mortality in the pediatric population. Most injuries include trauma to the head and spine, which can have significant long-term consequences. Although the reported incidence of such injuries is decreasing, many children are improperly restrained. In our study, only 2.3% of children were properly restrained, suggesting that proper child restraint and seating position could have prevented most injuries.
authors.affiliation: Department of Neurological Surgery, San Francisco Injury Center, University of California-San Francisco, San Francisco, California, USA.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Quiñones-Hinojosa
authors.forename: Peter
authors.initials: P
authors.lastname: Jun
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Manley
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Knudson
authors.forename: Nalin
authors.initials: N
authors.lastname: Gupta
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D017677:Age Distribution; D017278:Air Bags / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000009:adverse effects*; D007231:Infant, Newborn; D012307:Risk Factors; D012622:Seat Belts / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control