Play it safe Photo: Justin McManus
The rules are out of date, exposing our children to danger because they are not in appropriate car safety restraints, Fiona Surtees warns.
Many Australian parents are unwittingly risking their children's safety by putting them in ill-fitting car seats or allowing them to use seatbelts before they are tall enough.
According to the most recent Australian Transport Safety Bureau statistics, 53 Australian children aged 0-15 died while travelling in a car last year. Monash University Accident Research Centre advises that from 2000 to 2003, an average of 850 Australian children were seriously injured each year while travelling in a car. And the Transport Accident Commission says that in the year to November 2005, 149 Victorian child car passengers were seriously injured.
Road safety experts and child advocacy groups argue these statistics could be significantly reduced if restraint systems and baby seats were used properly.
If recommendations being considered by the National Transport Commission are adopted, infants may be forced to stay in rear-facing seats for longer, toddlers may be required to remain in forward-facing seats with a five-point harness until they are four, and older children may have to travel in purpose-built booster seats with a five-point harness until they are 140 centimetres tall. For most, that's close to their ninth birthday.
These proposals are unlikely to appeal to many parents or carers who have to wrestle three and four-year-olds into a car seat almost daily.
Cajoling image-conscious kids back into car seats may pose challenges, but road safety lobbyists, researchers and critical-care physicians argue that as things stand, we're exposing infants and young children to unnecessary risk. More often that not, our most precious cargo is sitting in the wrong-sized seat or in a poorly fitted restraint, wearing an adult seatbelt too early and even travelling in the front passenger seat.
"Parents gamble with their kids' safety," says Professor Mark Stokes, president of Kidsafe Victoria and professor of psychology at Deakin University. "Children are frequently overlooked by parents unaware of the danger. There's no malice; they do it because they assume that because nothing's gone wrong before, it won't now. But when things do go wrong, it's a disaster."
Trauma surgeon Professor Danny Cass says Australian children are far more vulnerable to injury in a car crash than children in Sweden, where it is standard practice to keep toddlers in rear-facing seats until their third birthday.
A 2003 study presented to a conference sponsored by the US-based Association for the Advancement of Automotive Medicine found that where booster seats were used by four-to-seven-year-olds, the risk of injury to the head, internal organs, spinal cord and for fractures was reduced by 59 per cent, compared with the risk for children in the same age group who were wearing seatbelts.
Dr Judith Charlton, an associate professor at the Monash University Accident Research Centre, says children who move into seatbelts too early are far more vulnerable to serious internal injury in a crash and to slipping out of the seatbelt.
For these reasons, Australian experts are pushing for legislative change and an extensive public education campaign to promote the proper use of appropriate, lifesaving child restraint devices.
While there is little doubt we understand the importance of child safety restraints - the RACV says usage rates for very young children exceeds 95 per cent - parents simply don't know which restraints provide the best protection for a child at each height or weight milestone. A common perception among parents and older children is that car seats are for babies, mirrored in last year's NSW Motor Accident Authority study that found the likelihood of a child being optimally restrained appeared to decrease after their second birthday.
Existing Australian laws only require infants less than 12 months old to be restrained in properly fitted and approved child restraints. In Victoria, infants are only required to be in the safer, rear-facing position until they are six months old or eight kilograms.
After their first birthday, children are supposed to be in an appropriate child restraint or, for older children, an adult seatbelt. But it's really been left to parents to decide what's "appropriate" for their child, Dr Charlton says.
According to VicRoads, the driver of the car is responsible for ensuring that children under the age of 16 are restrained correctly. It recommends keeping toddlers in car seats for as long as possible and suggests moving into an adult seatbelt only when the child's eyes are level with the top of the back seat or they weigh more than 26 kilograms.
There's very little information, even on the VicRoads website, about what's legal and what's not. But that may be about to change, with state transport ministers expected to vote this month to change the law to ensure that children up to the age of four are restrained in properly fitted, approved child seats.
Dr Charlton says more definitive laws on restraints for older children, plus an extensive education and awareness strategy, would keep children in cars safer and reduce parental uncertainty.
"The crash protection provided by a child restraint system is critically dependent on the right fit of a child in a restraint and the correct installation of the restraint system in a vehicle," she says.
Poorly fitted or adjusted car seats perform well below their capabilities. A 2001 RACV study found two-thirds of restraints were not installed properly - they were either placed incorrectly or the seatbelts and top tethers used to secure them were too loose.
The Australasian College of Surgeons is concerned about infants being exposed to unnecessary risk because they are being placed in forward-facing seats too early. Trauma surgeon Professor Cass says: "We don't even match the US or Canadian legislation, which states that infants should be rear-facing until 12 months of age."
He says rear-facing child restraints result in "significantly lower" levels of neck injuries and he questions the validity of legislation allowing older children to use an adult seatbelt.
Monash University Accident Research Centre last year surveyed 700 parents from Victoria and NSW and found that more than half of the children aged 4-11 were not in the appropriate restraint for their size.
Not surprisingly, this group of children - ideally in the booster seat age bracket - were over-represented as serious casualties and fatalities in crashes compared with children younger than five.
That's supported by the TAC's figures. Of the 149 Victorian children seriously injured while travelling in a car in the year to November 2005, 26 were aged 0-4, with the number more than doubling to 58 for those aged 5-10. Sixty-five children aged 11-15 were seriously injured.
The Monash study also revealed that many children are sitting in the front seat and graduating to seatbelts too early. Just 25 per cent of children aged 4-11 used booster seats; the rest travelled in seatbelts. Professor Cass says children younger than nine are generally too short and light for an adult-designed seatbelt. "We see tragic cases of critical internal injuries in kids caused by ill-fitting seatbelts."
It is common for Australian car-restraint manufacturers to give weight and age criteria for car seats, but internationally, height specifications are also provided.
Dr Charlton says a child's height is more important than age or weight, because height determines the position of the seatbelt across the shoulder and the hips.
Professor Stokes adds: "If you have the sash going across the face or neck, you can get quite a serious injury."
However, from an enforcement perspective, age is a simpler criterion.
Also, Dr Charlton says booster seats should be designed so they appeal to children and so that they actually want to stay in them until they are tall enough for a seatbelt.
What's next?
Quicker and easier to use - that's the promise for the next generation in children's car restraints modelled on the new European-style International Standards Organisation FIX. Cars will be manufactured with fixed attachment points and then the ISOFIX-compatible seats will be "clicked-in", eliminating the need for the vehicle seatbelt.
Monash University Accident Research Centre associate professor Judith Charlton says she would like to see the European system introduced here, although that would require a change in Australian Standards.
"Our research shows that restraints with rigid ISOFIX attachments, compared with a new US system called LATCH, provide superior crash protection, especially in side-impact crashes," she says.
However, safety engineer Michael Griffiths, who has been evaluating these systems as part of an Australian Standards committee on child restraints, does not believe the ISOFIX system (pictured) makes significant advances in safety.
"At some time in the future, it will be a benefit to Australian consumers to have access to these systems but at the moment, our system - with its long history of top tethers - is every bit as good as what's on offer," he says. "I think we need to wait and see how ISOFIX develops - the current versions are twice the weight and twice the cost of proven restraints and are not yet proving any easier to use."Belting up
The safety of child car passengers is an issue with historical ties for Kidsafe Victoria president Professor Mark Stokes, who, as a four-year-old in the early '60s, appeared in The Age with his two sisters as one of "the first children in Australia to wear a child seatbelt".
Professor Stokes' father Mark snr contacted the paper after reading an article about parents who were fitting car seatbelts for themselves but not their children. Outraged by the situation, he found a US-made restraint - which was similar to an old-fashioned over-the-shoulder harness that clipped into a belt running along the back of the seat - and fitted it to his car.
"We could jump up and down and move about - it wasn't particularly effective, but it was one of the first available," Professor Stokes says.
He believes today's parents have a good record of complying with child restraint recommendations but occasionally drop their vigilance due to the sheer number of times they put children in and out of the family car.
How do you choose?
The good news is, if you choose the right size restraint for your child and your car, all those on the market perform above the Australian Standard (1754) - deemed to be among the most stringent in the world. Standards Australia deputy chief executive Colin Blair says the standard is about to be revised to make it mandatory for manufacturers to design booster seats suitable for children as old as 10 - up from eight.
The RACV's Child Restraint Evaluation Program is also a useful guide for those wanting to choose the right car seat. The RACV rates seats on their performance in crash tests and for ease of use. Last year the RACV tested 17 restraints in three categories: restraints for infants weighing up to 9 kilograms, seats for children up to 18 kilograms and booster seats for children up to 26 kilograms. These cost from $90 for a booster seat to $506 for a child restraint.
In each of the three size categories, the best performing restraints were the Safe-n-Sound Baby Safety Capsule ($246), the Safe-n-Sound Series 3 ($189) child seat and the HiPod Barcelona booster seat ($229). RACV chief engineer Michael Case says: "One thing all three top-performing restraints have in common is that they are dedicated designs and do not have to perform two functions.
"We also found some notable difference between the top performers and lower-rating restraints. For example, the Safe-n-Sound Meridian infant restraint ($506), the Safe-N-Sound Maxi Rider ($299) child seat and the Babylove Bathurst ($90) were more difficult to use."
Mr Case says ease of use is critical, because of the increased risk of injury for a child in a poorly fitted restraint.
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