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Air Bag Safety for Kids

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: There's so much attention right now on passenger side air bags and who can't or can use them safely. I have read that children under the age of 12 years should not. What do they base that on? Surely, it cannot be just age, as all twelve-year-olds vary dramatically in height and weight. What are the safety guidelines for determining whether or not a passenger can sit in a front seat that has an air bag (we have a 1995 Dodge Caravan with four children)?

A: Your question is very provocative. Passenger-side airbags have gotten a lot of press lately. All new passenger vehicles will be equipped with passenger side airbags. Although designed to save lives, they still pose a very serious risk to children. In 1995, eight children died from airbag-related injuries; all were improperly restrained or not restrained at all. Thus, the American Academy of Pediatrics has made specific recommendations explained below.

As you correctly point out, children's heights and weights do vary widely with ages. Children are at increased risk for airbag-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 which, combined with the child's short stature, places the child's face and neck directly in the path and full velocity of the deploying airbag. Thus, the safest place for infants and children to ride is the back seat of the vehicle.

Whether the vehicle has an airbag or not, children are reportedly up to 29 percent safer riding in the back seat as compared to the front seat. Even with limited crash data, the National Highway Traffic Safety Administration currently recommends placing all children in the rear seat. In contrast, the American Academy of Pediatrics advises that the most important factor is the size (height and weight) of the child to ensure proper fit of the seat belt. Remember, the lap/shoulder belt should be used as follows: position the shoulder belt across the chest, the lap belt snug across the thighs. Most importantly, any child riding in the front seat must be correctly restrained. Airbags and other child's transportation safety issues are evolving at a very rapid rate, so keep your eyes and ears open.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.


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