By 1997, all new passenger vehicles will be equipped with passenger-side air bags. Although air bags were designed to save lives, they pose a very serious risk to children. In 1995 alone, 500 driver's lives were saved by air bags; eight children died from air bag-related injuries during this same period; all of whom were improperly restrained or not restrained at all. With increased exposure to air bags more will be at risk; the total number of reported deaths of children is 31.
     Children are at increased risk for air bag-related injuries because of their size. The vehicle seat belts, when worn, do not fit most children correctly. As a result, children often place the shoulder belt behind them and perch on the edge of the vehicle seat. This positioning, combined with the child's short stature, places the child's face and neck directly in the path and full velocity of the deploying air bag. This turns a minor 10-mile-per-hour crash into a 140-mile-per-hour head impact with the passenger-side air bag. The risk of death in a crash of a vehicle with a passenger-side air bag is extremely high for unrestrained children and for infants in rear-facing child seats.

In light of the above information, the AAP recommends the following:

1. The safest place for infants and children to ride is in the back seat of the vehicle. Children riding in the front seat are at risk if they are improperly restrained, out of position, or too small for the safety belt to fit correctly. In a crash, children can easily slide forward on the seat, and the inflating air bag can hit them in the head or neck. Whether the vehicle has an air bag or not, children are up to 29% safer riding in the back seat, as compared with the front seat. The National Highway Traffic Safety Administration currently recommends placing all children age 12 and under in the rear seat; however, the Academy advises that the most important factor is the size (height and weight) of the child to ensure proper fit of the seat belt (see chart on reverse side of this page).

    

2. In an emergency, if a child must ride in the front seat, make sure he or she is correctly restrained and then move the vehicle seat back as far as possible, away from the air bag.

    

3. Never put an infant in the front seat of a vehicle equipped with a passenger-side air bag. An infant weighing under 20 lbs or younger than 1 year must always ride in a rear-facing child safety seat in the back seat of the vehicle.

    

4. The child should be properly secured in the back seat of the vehicle in a child safety seat, a booster seat, or shoulder/lap belt correct for his or her size.

     With the intense media attention to this issue, your patients' families will turn to you as an important source of accurate information to help them make a decision about how to transport their children safely. Air bags and other child transportation safety issues are evolving at a very rapid rate.

     In the near future, the National Highway Traffic Safety Administration is expected to issue proposed rules concerning the availability of cut-off switches and circumstances where owners can have air bags disconnected.

     Please refer to the January 1997 issue of "AAP News" for additional detailed information from the Academy on this issue. An informational handout for parents also will be included in the January 1997 issue of "AAP News.":

Robert Hanneman, MD
President