Pediatrics, Vol. 117, No. 1, January 2006, pp. 9-14
Lauren Daly, M.D., Michael J. Kallan, M.S., Kristy B. Arbogast, Ph.D. and Dennis R. Durbin, M.D., M.S.C.E.
OBJECTIVE. The popularity of sport utility vehicles (SUV’s) is growing, and they are increasingly being used as family vehicles. Because of the large size of SUV’s, relative to passenger cars, parents may perceive that they are safer family vehicles. The objective of this study was to determine the relative risk of injury to children involved in crashes in SUV’s, compared with those in passenger cars.
DESIGN. These researchers looked at a sample of 3,922 child occupants, 0-to-15 years of age.
Injuries were defined as concussions and other brain injuries, spinal cord injuries, facial fractures and lacerations, internal organ injuries, extremity fractures, and scalp lacerations. [These injuries are not seen in our typical patients.]
Logistic regression modeling was used to compute the odds ratio (OR) of injury for children in SUV’s versus passenger cars, both unadjusted and adjusted, for several potential confounders, including differences in child seating position, restraint use, vehicle weight, exposure of the child to a passenger airbag, and whether the vehicle rolled over.
RESULTS. Among all children in the study, those restrained appropriately were less likely to be injured (75% less) and those in the front seat were more likely to be injured (106% more).
In both vehicle types, children exposed to a passenger airbag were more likely to be injured than were those who were not (370% more).
Rollover crashes increased the risk of injury in both vehicle types (increased by 229%) and occurred more than twice as frequently with SUV’s compared with passenger cars.
After adjustment for all of the aforementioned factors, the risk of injury was not significantly different.
Especially detrimental for children in SUV’s was being unrestrained versus restrained in a rollover crash (2400% increased risk with a range between 568% to 9253%). [WOW! Look at these numbers. If you have an SUV, make sure your children are properly restrained.]
CONCLUSIONS. Despite the greater vehicle weight of SUV’s, the risk of injury for children in SUV’s is similar to that for children in passenger cars.
The potential advantage offered by heavier SUV’s seems to be offset by other factors, including an increased tendency to roll over.
Age-appropriate child restraint and rear seat positioning are important, particularly for children in SUV’s, given the very high risk of injury for children restrained inappropriately in rollover crashes.
KEY POINTS FROM DAN MURPHY
1) This study only looked at seriously injured children, including brain injuries, spinal cord injuries, facial fractures and lacerations, internal organ injuries, extremity fractures, and scalp lacerations. Consequently, most of the patients we would see in the clinical setting were not included.
2) Children who are properly restrained are 75% less likely to be [seriously] injured compared to unrestrained children.
3) Children in the front seat are 106% more likely to be [seriously] injured than children sitting in the back seat.
4) In any vehicle, children exposed to a deploying passenger airbag were 370% more likely to be [seriously] injured than were those who were not.
5) SUV’s are 4 times more likely to roll over in a crash than passenger cars.
6) Rollover crashes increased the risk of [serious] injury by 229%.
7) Risk of [serious] injury increased 2,400%, with a range between 568% to 9,253%, for unrestrained children in SUV rollover crashes. [If you have an SUV, make sure your children are properly restrained.]
8) Despite the greater vehicle weight of SUV’s, the risk of injury for children in SUVs is similar to that for children in passenger cars, primarily because of the increased tendency for the SUV to roll over.
9) “Any potential safety advantage of the SUVs’ increased size and weight is offset by their increased likelihood of rolling over in a crash, compared with passenger cars.”
10) In this study, children in SUV’s had a 62% elevated risk of [serious] injury compared to children in passenger cars.
11) In both SUV’s and passenger vehicles, children exposed to a passenger air bag were more (370%) likely to be [seriously] injured than were those who were not.
12) In rollover crashes involving SUV’s, the risk of injury was 25-fold greater for unrestrained versus appropriately restrained children. (Range was 7-fold to 94-fold increased risk.)
13) There is a 25-fold increased risk of injury to unrestrained child occupants in an SUV rollover crash.
14) In rollover crashes, 50% of unrestrained occupants are ejected from the vehicle, and 62% of those ejected will die.
15) Only 4% of restrained occupants are ejected in rollover crashes.
16) Because of the higher risk of rollover, there is strong importance for the use of age-appropriate restraint for all children who ride in SUV’s.
17) The increased risk of injury posed by deploying passenger air bags in any vehicle “reinforces the importance of continued education of parents to never place children less than 13-years-old in the front seat of a passenger air bag-equipped vehicle.”
A 1978 graduate of Western States Chiropractic College, Dr. Dan Murphy is on the faculty of Life Chiropractic College West, and is the Vice President of the International Chiropractic Association. For more information, visit