Reducing Risk to Children on Planes, Buses

Shortly after the Sioux City crash, five of United’s flight attendants revealed that some men couldn’t assume the “brace position” because the seats were too close and that babies under 2, assigned no seats, were virtually loose in the plane. They precipitated a debate rivaling the obsession with the question of which seat locations had proved the safest. Not surprisingly, the baby dilemma was most compelling, as people weighed the cost of another seat, and maybe a special restraint, against the relatively low risk of crashing.

But the issue isn’t just babies or seat belts. It’s whether any safety aids can truly guarantee safety, whether they should be provided anyway and at what cost. This is modern risk assessment, and we’ve seen it before.

Take school buses. Most don’t have seat belts, are said not to need them or don’t need them enough to justify the cost. At the same time, auto manufacturers must install them in cars, vans and trucks, two-thirds of the states require some seat belt use and all require special restraints for the youngest children.

‘Why Not?’

Many people naturally assumed that if seat belts make private vehicles safer, they’d help on school buses too, and school districts across the country began requiring their installation. Similar proposals were debated in state legislatures (California’s, for example), and passed in one--New York, which required belts on buses manufactured after July, 1987. “Our feeling was, why not?” says John Boffa, spokesman for the governor’s traffic safety committee. “There wasn’t a lot of research indicating seat belts were not good.”

There is now, however. Indeed, in recent years, one official study after another has concluded that seat belts won’t make today’s school buses safer and has advised against their installation.

Given the 4 billion miles that 25 million U.S. schoolchildren travel on them annually, riding in school buses is already four times safer than riding in passenger cars, according to a recent report requested by Congress from the National Research Council’s Transportation Research Board. There are relatively few accidents and even fewer serious injuries or fatalities.

For one thing, school buses--at least the larger ones--are safer vehicles. Eighty percent of our 390,000 school buses weigh more than 10,000 pounds and carry more than 24 passengers, and three-quarters of them were built after 1977, when current federal standards first applied. They have reinforced roofs (for roll-overs), shatterproof glass, protective cages around gas tanks and stronger seats with higher backs and more padding back and front to “compartmentalize” the children, buffering them against a crash.

They’re also inspected regularly and carefully maintained, as, in a way, are their drivers, usually trained to a higher standard of safe driving. Their movement, too-- generally low-speed, stop-and-go trips along routes familiar to the driver--is safer than that of private cars, tour buses, even buses chartered for special school outings.

Side Impact Most Common

As a result, school bus accidents are also different, and 90% of passengers involved sustain no injuries or only minor ones, according to the National Transportation Safety Board. In fact, said the NRC report, nearly 40 children annually are killed boarding or leaving a bus--two-thirds struck by their own bus--compared to 10 fatalities to riders.

The most common collisions, and the least severe, said the California Highway Patrol, are side impacts--someone else sideswiping the bus--and seat belts might indeed mitigate the effects of a secondary impact with the bus sides or other passengers. They would also help in a bus roll-over (rare) but make no difference to a child injured because he was in what the National Transportation Safety Board called “direct line with the crash forces,” i.e., seated right where a truck hit or a floor buckled.

The head-on crashes that generally cause more severe injury also cause the most debate, because crash tests with dummies have indicated that lap belts would actually cause harm, making the body jackknife and the head hit the seat in front. Unbelted, “the whole body takes the impact,” says Bud Dunevant, transportation director for Los Angeles’s Unified School District. But there has been no analysis of actual damage attributable to seat belts on school buses because so few have had them--”less than 0.2% of the total fleet” nationwide, the CHP reported in 1987.

The National Research Council’s summary conclusion, however, was that “seat belts, when properly used on large post-1977 buses, are not inherently harmful.” Indeed, if all school buses had them and only half the students used them, “one life might be saved and (four) dozen serious injuries might be avoided each year”--a 20% reduction in their current risk. But installation and maintenance would cost $43 million a year, compared to $6 million to raise seat backs to 24 inches, possibly saving three lives and 95 injuries.

A similar assessment could emerge from the incipient debate about securing babies on planes. Special infant seats--the familiar car seats--aren’t provided by airlines, nor could passengers bring their own until 1982, when the FAA allowed (but didn’t require) the use of approved models. Even then, airlines said nothing, preferring to promote free travel for babies held on a parent’s lap.

Air travel, too, is statistically safe, and injuries to small children therefore few--an estimated one to three fatalities a year and 10 to 30 “significant” injuries in survivable crashes, wrote Pennsylvania pediatrician Fred Henretig, a member of the American Academy of Pediatrics section on emergency medicine. But that’s six to 10 times the adult’s risk, he reported, and could be reduced “one-half to two-thirds” by use of approved car seats.

The question is whether that reduction is worth the $40-$50 it would cost airlines to provide such restraints and the cost to parents of reserving another seat. Leaving it an individual option may be the best answer, as is leaving seat belt installation to individual school districts. Legislators and regulators need guarantees that safety measures will help, and accidents are by nature unpredictable. Parents take actions just because they might help.