Child’s Tragedy Inspired Doctor’s Safety Mission

Nineteen years ago, Phyllis Agran gave a 1-year-old girl a routine physical. Later the same day, she saw the child in an emergency room with a serious head injury from an automobile accident. The toddler had been sitting on the lap of an adult in the front seat, and the impact of the collision had crushed her head against the dashboard.

“It was very upsetting,” recalls Agran, a professor of pediatrics at the UC Irvine. “This was a minor crash and the injury could have easily been prevented.”

The case provided the inspiration in 1981 for Agran to found the Pediatric Injury Prevention Research Group, which has been a major force in enacting child safety legislation.

“Kids have to be protected,” says Agran, mother of a 26-year-old son and wife of Larry Agran, the former mayor of Irvine and one-time presidential candidate.

Not surprisingly, the first issue the group tackled was the lack of seat belts or car seats for children. Agran and her fellow researchers created an elaborate system, one of the first of its kind in the country, to collect and analyze information on pediatric injuries from hospitals throughout Orange County.

One of their first findings was that, as they suspected, infant car seats were not being widely used and that unrestrained children were injured more often in accidents and more seriously than those in car seats.

Agran and her researchers published their conclusions and presented them to the Legislature. In 1983, persuaded in part by her research, California enacted a law requiring children under the age of 4 to be restrained in car seats.

The same information three years later was instrumental in passage of a law requiring all passengers to wear seat belts.

Over the years, the pediatric injury research group has made other discoveries with far-reaching effects:

* A study in the early 1990s documented how dangerous it is for children to ride in the back of a pickup. The study showed children are 26 times more likely to be ejected from a truck bed during an accident than they are from a regular car. The study led to the enactment in 1994 of a state law prohibiting anyone from riding in the back of a truck.

* Information showing the likelihood of injuries to fetuses from auto accidents resulted in recommendations to women and obstetricians, now standard care, that pregnant women have their unborn babies checked even if they themselves are uninjured in an accident.

* A study showing the seriousness of bicycle injuries led to a 1994 law requiring children riding bikes to wear helmets.

* Data showing a high number of incidents in which children left alone in cars had shifted them into gear, causing the vehicles to roll, led the National Highway Traffic Safety Administration to require that transmissions be built with locks.

* The discovery that a disproportionately high number of Latino children get hit by cars after dashing into the streets of Orange County led to educational programs aimed at that community.

*

Currently, according to Agran, the group--which gets its funding from agencies ranging from the national Centers for Disease Control to the National Institute of Child Health and Human Development--has three major areas of focus.

Armed with the data from their study of Latino children, they are talking to medical experts as well as city engineers in the hopes of modifying high-risk neighborhoods in Orange County to make them less dangerous to kids. Among the ideas being discussed, Agran said, are reducing speed limits, reducing curbside parking, cutting back on shrubbery to increase visibility, adding speed bumps and narrowing streets.

The group is also working with medical anthropologists to learn more about what parents perceive as risks to their children and how they cope with them. Once they understand that, Agran says, they will be better able to design programs to which parents will respond.

Finally, they are working to further analyze pickup truck injuries, in particular those resulting from accidents involving trucks with camper shells. Eventually, Agran says, the group hopes to suggest legislation that would greatly reduce the risk of injuries related to trucks.

Fueling all of it, of course, is Agran’s love of children.

“My own son made it through relatively injury free,” she says. “I attributed it to luck and child restraints.”

Even today there are times when the original impetus for all her research returns to symbolically bite her on the nose.

“When I see a child sitting on the lap of an adult in a car,” the pediatrician says, “I feel like pulling them over. Sometimes I do.”

Street Smart appears Mondays in The Times Orange County Edition. Readers are invited to submit comments and questions on traffic, commuting and what makes it difficult to get around in Orange County. Include simple sketches if helpful. Letters may be published in upcoming columns. Please write to David Haldane, c/o Street Smart, The Times Orange County Edition, P.O. Box 2008, Costa Mesa, CA 92626, send faxes to (714) 966-7711 or e-mail him at David.Haldane@latimes.com. Include your full name, address and day and evening phone numbers. Letters may be edited, and no anonymous letters will be accepted.