Children's lives at risk over use of car lap belts, doctors warn
Doctors have warned that children's lives are being put at risk by the use of lap belts in the back seats of cars.
A study has found that one child died and a number of others were seriously injured in crashes in just one year while wearing only lap belts.
The use of adult seat belts without booster seats for young children can lead to severe abdominal, lumbar or cervical spine injuries, as well as head and neck injuries.
The doctors -- from Temple Street Children's Hospital in Dublin -- said lap-belt injuries in a single year resulted in the death of one child and long-term disability in two others.
"It highlights the dangers of using lap belts without shoulder straps," the doctors warn in a study published in the 'Irish Medical Journal'.
Appropriate child safety seats are recommended for pre-school children; until a child fits properly in a seat belt, booster seats and booster cushions should be used.
"Standard lap belts are designed to restrain an adult just below the centre of gravity at the pelvis," the report found.
"However, the immature anatomy of a child's pelvis cannot provide anchor points for the belt until the child is at least 10 years old, as in children the lap belt lies across the lower or mid abdomen rather than at pelvis level."
The children who suffered injuries from lap-belt syndrome over a year ranged in age from 22 months to 10 years.
All were rear-seat passengers in serious motor accidents -- one child died 24 days later, while another is a quadriplegic and needs mechanical ventilation two years on.
The child who died was a 22-month-old girl who was a back-seat passenger in a baby car seat with a lap belt on.
In another case, a 10-year-old girl was in the back seat at the time of the crash and had unhooked the shoulder strap.
She was found semi-conscious with loss of lower limb function and extensive abdominal bruising. She had paralysis of the lower limbs.
A nine-year-old girl was in a back seat with just a lap belt on and she had to be resuscitated in hospital. She is also paralysed in the lower limbs.
The authors pointed out that a very high proportion of five to nine-year-olds use adult seat belts instead of a booster seat or cushion. "Often when shoulder straps are available they are not used because they tend to ride up on to the face of a small child," they said.
When a car suddenly decelerates, it can cause the spine to flex at the upper lumbar level rather than at the hips, which can result in severe injuries of the abdomen and of the lumber spine.
"Children should be restrained by means of a three-point anchor and this is only achieved by means of using a shoulder strap, in addition to a lap belt," they added.