Those flashy new cars may have improved on safety for the parents in the front seat, but fewer improvements have been made for the child who may be sitting in the back seat, researchers report.

The National Highway Traffic Safety Administration reports that in the U.S. during 2002, there were 44,065 deaths due to motor vehicle crashes and that crashes were the leading cause of death for ages three to 33 years.

New safety features such as crumple zones, collapsible steering columns, new seat belts, and airbags have been installed. But University of Pennsylvania School of Medicine researchers have found that those safety measures implemented in newer cars favored the driver rather than those in the backseat.

“It is five times more common for the child to do worse than the driver in crashes in new models of cars than older,” says Flaura K. Winston, MD, PhD, director of TraumaLink, an injury research center in Philadelphia. Winston is also an assistant professor of pediatrics at the University of Pennsylvania. She spoke at the American Academy of Pediatrics (AAP) National Conference and Exhibition.

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Crash Patterns

The researchers looked at “discordant injury.” It’s a crash pattern in which the child alone is injured and the driver is favored, or the driver alone is injured and the child is favored.

Researchers then determined whether the driver or the child had excess risk of injury. Excess child-risk crashes were defined as those crashes in which the child passenger was injured but the driver was not. Nonexcess child-risk crashes were defined as crashes in which both the driver and child passenger were injured or crashes in which the driver but not the child passenger was injured.

They compared crashes in car models from 1990 to 1993 to models from 1998 to 2004. The study was limited to crashes in which at least one child occupant or driver was injured. All the children were restrained.

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Child Safety vs. Adult Safety

The researchers teamed up with State Farm Insurance to study how and why children are injured in crashes. Together, they did telephone interviews and on-site crash investigations in 15 states during 2003.

What they found was that the number of drivers injured in the newer cars dropped about 25 percent, while the number of children injured remained similar to the number injured in older cars.

Older model cars were 78 percent less likely to be in excess child-risk crashes, says Winston. Additionally, male children are twice as likely to be involved in excess child-risk crashes.

“Similar attention to safety in the rear seat as the front seat could benefit children,” Winston says. “If manufacturers can protect an adult, they can protect a child.”

“The safety of an adult improved by 25 percent in the newer cars,” she says. “Why not improve the safety of a child by the same 25 percent?”

Carden Johnston, MD, former president of the AAP, says this was a carefully designed study using credible information. “The only way to make progress in preventing accidents -- a leading cause of death in children -- is research. Child passenger safety is an evolving science.”

This study points to the need of improved safety for rear seat passengers, which isn’t coming along as fast as safety improvements for those in the front seat, he says.

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By Linda Little, reviewed by Louise Chang, MD

SOURCES: American Academy of Pediatrics National Conference and Exhibition, Washington, D.C., Oct. 8-11, 2005. Flaura K. Winston, MD, PhD, director, TraumaLink, Philadelphia. Carden Johnston, MD, former president, American Academy of Pediatrics. National Center for Statistics and Analysis, National Highway Traffic Safety Administration.