Morse Amber M, Aitken Mary E, Mullins Samantha H, Miller Beverly K, Pomtree Mindy M, Ulloa Erin M, Montgomery Jeffrey S, Saylors Marie E
From the Division of Emergency Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas.
J Trauma Acute Care Surg. 2017 Aug;83(2):305-309. doi: 10.1097/TA.0000000000001543.
Current American Academy of Pediatrics recommendations regarding transition from child safety/booster seat to adult safety belt use indicate that children should be at least 4 feet 9 inches, 8 years old, or 80 pounds. Proper fit in the vehicle seat, assessed with a five-point fit test, should also be met. Although most children reach 4 feet 9 inches around age 8 years, each child and vehicle presents a unique combination; thus a child may not fit appropriately in all vehicle types using only the 4 feet 9 inches requirement.
We enrolled children, aged 7 years to 12 years, into our study. Height, weight, and demographic data were obtained. A Child Passenger Safety Technician then performed the five-point fit test in each of a uniform lineup of five vehicles. Data were collected on fit in the standard vehicle seat and also in a booster seat. We set 90% as the threshold proportion of children who meet all criteria for proper fit to validate current recommendations of a height of 4 feet 9 inches.
Data were collected on 388 children. The percentage of 90% proper fit was met in the compact car and small sport-utility vehicle (SUV). However, only 80 (77%) of 104 students (p < 0.0001) that were 4 feet 9 inches or higher fit properly in the large SUV, only 87 (83%) of 105 students (p = 0.02) fit properly in the pickup truck, and only 91 (89%) of 102 students (p = 0.74) fit properly in the minivan.
Substantial proportions of children meeting current height guidelines for an adult seat belt do not meet safety requirements for fit, especially in larger, commonly used vehicles (large SUVs and trucks). This emphasizes the need for evaluation of fit by a trained personnel and/or development of standard back seat dimensions in all vehicles for maximum safety.
Epidemiologic study, level III; Therapeutic study, level V.
美国儿科学会目前关于从儿童安全座椅/增高座椅过渡到使用成人安全带的建议指出，儿童身高应至少达到4英尺9英寸、年龄满8岁或体重达80磅。还应通过五点式合身测试来评估儿童在车辆座椅中的合适度。尽管大多数儿童在8岁左右能达到4英尺9英寸，但每个孩子和车辆都有独特的组合；因此，仅依据4英尺9英寸这一要求，孩子在所有车型中可能都无法获得合适的乘坐效果。
我们招募了7至12岁的儿童参与研究。获取了他们的身高、体重和人口统计学数据。随后，一名儿童乘客安全技术员在五辆统一配置的车辆中，对每个孩子进行了五点式合身测试。收集了儿童在标准车辆座椅以及增高座椅中的合身数据。我们将90%设定为符合所有合适度标准的儿童比例阈值，以验证当前4英尺9英寸身高建议的合理性。
共收集了388名儿童的数据。紧凑型轿车和小型运动型多用途汽车（SUV）中达到90%合适度的比例。然而，在大型SUV中，身高4英尺9英寸及以上的104名学生中只有80名（77%）合身情况合适（p < 0.0001），在皮卡中，105名学生中只有87名（83%）合身情况合适（p = 0.02），在小型货车中，102名学生中只有91名（89%）合身情况合适（p = 0.74）。
相当比例的儿童虽然达到了当前成人安全带的身高指导标准，但并不满足合身的安全要求，尤其是在较大的常用车辆（大型SUV和卡车）中。这凸显了由训练有素的人员进行合身评估和/或为确保最大安全性而制定所有车辆标准后排座椅尺寸的必要性。
流行病学研究，III级；治疗性研究，V级。
