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 Nov;83(5S Suppl 2):S179-S183. 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 level 1.
目前美国儿科学会关于从儿童安全/增高座椅转换为成人安全带使用的建议指出，儿童应至少 4 英尺 9 英寸高，8 岁或 80 磅重。同时，还应通过五点-fit 测试评估车辆座椅的适配性。虽然大多数儿童在 8 岁左右达到 4 英尺 9 英寸，但每个儿童和车辆都有独特的组合；因此，仅靠 4 英尺 9 英寸的要求，儿童可能无法在所有类型的车辆中都适配得当。
我们招募了 7 至 12 岁的儿童参与我们的研究。获取了身高、体重和人口统计学数据。然后，一名儿童乘客安全技术人员在一组统一的五辆汽车中进行了五点-fit 测试。收集了标准座椅和增高座椅的适配数据。我们将 90%作为满足所有适配标准的儿童比例的阈值，以验证 4 英尺 9 英寸的现行建议。
共收集了 388 名儿童的数据。在紧凑型车和小型运动型多用途车（SUV）中，达到 90%适配的比例为 5%。然而，只有 104 名 4 英尺 9 英寸或更高的学生中有 80 名（77%，p < 0.0001）适配大型 SUV，105 名学生中有 87 名（83%，p = 0.02）适配皮卡，102 名学生中有 91 名（89%，p = 0.74）适配小型货车。
达到现行成人安全带高度标准的儿童中，相当大比例的儿童在适配性方面不符合安全要求，尤其是在较大的、常用车辆（大型 SUV 和卡车）中。这强调了需要由经过培训的人员评估适配性，或者为所有车辆制定标准的后座尺寸，以实现最大安全性。
流行病学 1 级。
