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Child Passenger Safety Technician Technical Webinar July 17, 2014

California Department of Public Health Vehicle Occupant Safety Program with the support of California Office of Traffic Safety through the National Highway Traffic Safety Administration. Child Passenger Safety Technician Technical Webinar July 17, 2014. Stephanie M. Tombrello , LCSW, CPSTI

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Child Passenger Safety Technician Technical Webinar July 17, 2014

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  1. California Department of Public Health Vehicle Occupant Safety Programwith the support of California Office of Traffic Safety through the National Highway Traffic Safety Administration Child Passenger Safety TechnicianTechnical Webinar July 17, 2014 Stephanie M. Tombrello, LCSW, CPSTI Kate Quirk, PhD, CPSTI SafetyBeltSafe U.S.A. www.carseat.org

  2. Training Opportunities: Situated in Los Angeles County • Proposed Regulatory Change: Side-Impact Testing • New Safety Seats: Convertibles/Combination • Most Recent Recall • Research: Are Boosters Effective? Topics SafetyBeltSafe U.S.A. www.carseat.org

  3. Educator Workshops (3 CEUS for Techs, 6 for nurses): • Friday, July 25, Lynwood Recreation & Community Services Center • Tuesday, September 16, Family Health Education Ctr, Long Beach • Safety Seat Checkups: • Saturday, July 26, St. Francis Medical Center, Lynwood • Saturday, September 20, Harbor-UCLA Medical Center, Torrance • National CPS Certification Course – Fall 2014, dates TBA TrainingOpportunities: L.A. County SafetyBeltSafe U.S.A. www.carseat.org

  4. 49 CFR Part 571; Docket No. NHTSA-2014-0012 RIN 2127-AK95 • 25 Comments submitted by April 28 on NPRM, backed by Congressional action in 2002 requiring action. • NHTSA has reopened comment period till 10/2/14 due to JPMA letter, noting Q3 dummy unavailable for companies to pre-test. • Covers research basis for proposal; dummy to be used; and proposed test architecture. • Addresses proposed test approach submitted by Dorel Juvenile Group & Kettering University. Proposed Regulatory Change: Side-Impact Testing SafetyBeltSafe U.S.A. www.carseat.org

  5. Crash exposure for under age 12: 2005-2009: • Frontal: 32%; side impact: 31%; rollovers: 25%; rear end: 11% • More than half side impacts were “near-side”; all move toward point of impact. • 75% side-impact fatalities: under age 4 • Substantial injury for safety seated: 43% frontal; 33% side (2/3rds of those from near side); 15% rollovers; 9% rear enders Proposed Regulatory Change: Side-Impact Testing SafetyBeltSafe U.S.A. www.carseat.org

  6. NHTSA data (1996) on safety seat effectiveness: • Infants – 71% in cars, 59% in trucks; • 1–4 year olds – 54% in cars, 59% in trucks • Fatality data for frontal & side crashes for children from birth to age 3 (NHTSA, 1995-2009): • 52% effectiveness in frontal crashes • 42% effectiveness in side impacts (excluding crashes with rollovers) Proposed Regulatory Change: Side-Impact Testing SafetyBeltSafe U.S.A. www.carseat.org

  7. Assn. for Advancement of Automotive Medicine Report (Sherwood et al., 2003): • Half of crashes unsurvivable. • Of rest: 12% gross child seat misuse • 16% side impacts • 12% in frontals that might have been survivable. • 40% of fatalities were in side impacts – the highest number. All included vehicle intrusion into the child’s seating position. Proposed Regulatory Change: Side-Impact Testing SafetyBeltSafe U.S.A. www.carseat.org

  8. Characteristics of Crash Fatalities0-12 years: 2005-09 • 36% unrestrained. Of those with known restraint use, 38% in safety seats. • Safety seat use varied: • Under age 1: 76% • 1 – 3 year olds: 65% • 4 – 7 year olds: 28% • 8 – 12 year olds: 2% • Three-quarters of fatalities were children under age 4. • Thus, NHTSA contends most effect from improved safety seats would reduce deaths of under 4 year olds

  9. Vehicle Improvement FMVSS 214 • Stronger vehicle requirements for side impact protection, including side air curtains. • BUT youngest children ride too low for air curtain protection. • NHTSA is building the regulation on the current vehicle structure & findings; quite diverse range for seat back angles, armrest protrusion into cabin.

  10. Side-Impact Crash Test Proposal: The Takata Test • Sled-test: forward-moving sled travelling at 15 mph, ‘T-boned’ at 30 mph. • Child restraint placed on near-side of impact. • Based on characteristics of testing for FMVSS 214 (tests of car side-impact protection). • Modeled on typical side-impact crash (vehicle starting into intersection slowly hit by vehicle “running” into intersection); vehicle seat moves sideways so top of safety seat strikes intruding door.

  11. Side-Impacts: Safety Seat Motion As collision occurs, lower part of safety seat moves toward far side, sending top of seat and child’s head toward intrusion.

  12. Test Dummies • NHTSA chose: • CRABI (12 month old): measures containment rear facing • Q3s (32-lb. 3 year old), used in Europe, to measure head injury and chest deflection. • Measure head & thoracic forces to replicate real world. • JPMA successfully petitioned for longer to submit comments (120 days more) due to paucity of Q3s dummies with which to test.

  13. Findings on Current Safety Seats • NHTSA proposal contains specific preliminary test data on current rear-facing-only, convertible, & combination seats. • Test will allow head contact with door as analysis shows peak stress on head occurs prior to door strike from hitting seat “wings”. • Rear-facing seats: must contain baby’s head. • Forward-facing seats: chest deflection, head injury criteria will be assessed.

  14. NHTSA ‘Predictions’ • With 3 years of lead time to meet standard, manufacturers will be able to lengthen head wings or add more force-handling padding on current seats with little disruption. • Boosters without backs will not pass; can be labeled for children 40 lbs.+ • Boosters with backs may strengthen head area OR mandate use by those 40 lbs.+

  15. Findings of ‘Fleet’ • Rear-facing-only seats: of 12 seats, only Combi Shuttle allowed head contact with door. • Forward-facing seats: at least 75% of head must be enclosed by wings if want to prevent injury. • ‘Good design’: Britax Advocate & Dorel Air Protect • ‘Average’: majority of seats • ‘Poor design’: Evenflo Chase & Diono Radian 65.

  16. How Big is the U.S. Safety Seat Market? • 7.42 million child restraints sold annually. • Cost for tests: less than $1 per seat.

  17. How Will Seats Be Installed? • Rear-facing seats: lower anchors only. • Forward-facing seats: LATCH (lower anchors & tether).

  18. What is Missing? • Incorrect use, esp. without tether attached given that observational data suggest widespread lack of tethering: • NHTSA: at least 30% non-use. • IIHS: 57% non-use overall, 83% non-use in pickup trucks (sample size: 1500) . • Shoulder-lap belt/lap belt installation: • NHTSA data indicate method of attachment (belt vs lower anchorages) shows no meaningful differences. • Lap belts are no longer legal in back seat. • Shoulder-lap belts tend to mimic tether use.

  19. What is Missing? • No testing with dummy over 40 lbs. • No testing of belt-positioning boosters rated above 40 lbs. (Will likely affect marketing of boosters.)

  20. BritaxHighway • 5 – 40 lbs rear-facing, 20 – 65 lbs forward-facing • 4 sets of harness slots • 2-position crotch strap • 3-position recline • Lock-offs • Can install with inflatable safety belt but do not use lock-offs • Tether for rear- & forward-facing use • Infant positioning pillow up to 22 lbs New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  21. BritaxRoundabout • 5 – 40 lbs rear-facing, 20 – 55 lbs forward-facing • 4 sets of harness slots • 2-position crotch strap • 3-position recline • Lock-offs • Inflatable safety belt: can install with Ford only, but do not use lock-offs • Tether for rear- & forward-facing use • Infant positioning pillow up to 22 lbs New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  22. DionoOlympia • 5-45 lbs rear-facing • 20-70 lbs forward-facing • 50 – 110 lbs booster (+ shoulder height limit) • Shoulders may be above slots (up to 57” tall) • 5 sets of harness slots, 2-position crotch strap • Tether – rear & forward-facing use • Adjustable sides • Safe Stop attachment f/f 20 – 40 lbs • 2 sets of harness pads (under and over 65 lbs) • Expiration: 8 yrs (harness) 12 yrs (booster) New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  23. DionoRainier • 5-50 lbs rear-facing, 20-90 lbs forward-facing • 50-120 lbs booster mode (+ shoulder height limit) • 12-position headrest • DionoPacifica • 5-50 lbs rear-facing, 20-90 lbs forward-facing • 50-120 lbs booster mode New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  24. Dorel Advance 65 Air + • 4-40 lbs rear-facing • 22-65 lbs forward-facing • 10-position adjustable headrest • 3 crotch strap positions • 4-position recline New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  25. Dorel Summit 65/Eddie Bauer Deluxe Highback 65 • 22-65 lbs (harness) • 40-100 lbs & 4 years (booster) • 4-position headrest • 3-position crotch strap New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  26. GracoArgos 65 • 20-65 (harness) • 30-100 lbs (highback booster) • 40-120 lbs (backless booster) • 5-position, no re-thread harness • 2-position crotch strap • 3-position recline adjustment • 10-year expiration • Booster mode – must be fully supported by vehicle seat New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  27. GracoContender 65 • 5-40 lbs rear-facing • 20-65 lbs forward-facing. • 8-position headrest • Adjustable crotch strap • Dual angle indicator • Infant insert • Similar appearance to My Ride 65 but different pillows/body supports. New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  28. GracoFit 4 Me 65/Headwise 65/My Size 65/Size4Me 65 New Safety Seats • 4-40 lbs rear-facing • 20 – 65 forward-facing • 8-position headrest • 2-position crotch strap • 3-position recline SafetyBeltSafe U.S.A. www.carseat.org

  29. Graco4Ever • 4-40 lbs rear-facing • 20-65 lbs forward-facing • 30-100 lbs highback booster • 40-120 lbs backless booster • 10-position headrest • 2-position crotch strap • 6 recline positions (f/f recline ok) • 10-year expiration • Booster mode – must be fully supported by vehicle seat New Safety Seats SafetyBeltSafe U.S.A. www.carseat.org

  30. Graco rear-facing-only safety seats—not all models Problem: May be difficult to release buckle which could lead to risk in an emergency Solution: Call 877/766-7470 or go to GracoBuckleRecall.com Graco also shows how to clean buckle; however, we recommend replacement. Recall: Most Current SafetyBeltSafe U.S.A. www.carseat.org

  31. Specific Graco Seats Involved: SnugRide, SnugRide Classic Connect: 3/1/11 to 5/31/13 SnugRide 30, SnugRide Classic Connect 30: 7/1/10 to 1/31/13 SnugRide 35, SnugRide Classic Connect 35: 5/1/11 to 1/31/13 SnugRide Click Connect 40: 6/1/12 to 12/31/12 Listed on SafetyBeltSafe U.S.A. List of Recall and Replacement Parts; seats removed from section listing Graco seats without recalls/replacement parts Recall: Most Current SafetyBeltSafe U.S.A. www.carseat.org

  32. New and Improved Harness Buckles If your car seat currently has one of these buckles, it is not included in this recall. New buckles come in black and gray. Recall: Most Current SafetyBeltSafe U.S.A. www.carseat.org

  33. ‘Effectiveness of Booster Seats Compared With No Restraint or Seat Belt Alone for Crash Injury Prevention’, Ma et al. • Academic Emergency Medicine (2013) • Analysis of 514 children in crashes from National Automotive Sampling System. Findings: • No overall decrease in injury through use of boosters over safety belts alone. • Significant increase in risk of neck injury among booster users. Research: Booster Seat Effectiveness SafetyBeltSafe U.S.A. www.carseat.org

  34. Cautions: • Many other studies have found increased effectiveness of boosters over belts alone. • Research sample included: • Children age 0 – 10. • Children using lap-only belt with booster. • Increase in injuries found in least severe category (minor abrasions, sprains etc.). Research: Booster Seat Effectiveness SafetyBeltSafe U.S.A. www.carseat.org

  35. Pickrell, T. M., & Choi, E-H. (2014, June). The 2013 national survey of the use of booster seats. (Report No. DOT HS 812 037). Washington, DC: National Highway Traffic Safety Administration • National probability sample in which adult with child is interviewed as well as child’s seat use observed • Goal: to observe restraint use of children ages 4 to 7 in 2013 compared with 2011. • Key finding: overall restraint use for under age 13 at 91% is similar to 2011; but significant changes found in details summarized below. Research: Booster Seat Usage Rates SafetyBeltSafe U.S.A. www.carseat.org

  36. Details of Findings: Clues for Outreach Focus • Use of any kind of restraint declines with age: • Birth to 12 months: 95%. By age 12: 89%. • Significant changes: 1-3 year olds: rear facing 10% (7% 2011) • 7% in boosters, a decrease of 5%; • Restraint usage for white children (non-Latino) rose to 95% from 91% for ages 8-12. • For all ages 1 to 12 years, white and Asian children had much higher restraint usage than black and Latino children riding with adults ages 25-69. • But for Asian children 8-12, usage fell to 86% from 95% in 2011. Usage for black children, age 8-12, was only 69%. Research: Booster Seat Usage Rates SafetyBeltSafe U.S.A. www.carseat.org

  37. Details of Findings: Clues for Outreach Focus • 2% increase in use of forward-facing seats with harnesses for 4-to-7 year olds to 20% • 1% decrease in belt use instead of safety seat use for 4-to-7 year olds to 24%. • Occupants in vehicles with children: for 13-15 year olds, Latino at 93% usage was higher than white teens, 92%, & much higher than black teens, 75%. • For main age group, 25-69, black adults at 81% usage were much lower than Latino, 88%, and other groups at 94%. Research: Booster Seat Usage Rates SafetyBeltSafe U.S.A. www.carseat.org

  38. Jan Null, www.ggweather.com/heat • Statistics • Average number of child deaths from heatstroke after being left in cars each year: 38 • Deaths in 2013: 44 • Deaths so far in 2014: 17 • Circumstances • 51% child “forgotten” by caregiver • 29% child playing in unattended vehicle • 18% child intentionally left in vehicle • 1% unknown Research: Hyperthermia SafetyBeltSafe U.S.A. www.carseat.org

  39. Ages • 31% less than 1 year • 22% 1 year • 20% 2 years • 14% 3 years • 6% 4 years • 10% 5 years + Research: Hyperthermia SafetyBeltSafe U.S.A. www.carseat.org

  40. Demographics of Persons Responsible for Child Victims Accidentally Left in Vehicle (312 children, 1998 - 2013) Research: Hyperthermia SafetyBeltSafe U.S.A. www.carseat.org

  41. Education Messages • Buckle an essential item into the back seat • ‘Look Before You Lock’ • Keep a stuffed animal in child’s safety seat; put in front when baby in seat.. • Arrangements for calls to be placed with daycare/babysitters. • Keep vehicles locked at all times, and keys away from children. • Be especially careful at busy or stressful periods. Research: Hyperthermia SafetyBeltSafe U.S.A. www.carseat.org

  42. 1 CEU awarded by Safe Kids • To claim: • www.carseat.org • Click on Calendars, Professional and Technician Training, California Technical Teleconference, Request for CEU • Download form, complete & email to i0680@hotmail.com • Verification Code: 625Anniversary CEUs SafetyBeltSafe U.S.A. www.carseat.org

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