Putting the brakes on vehicular injuries

young driver with cell phone

In July of 1995, a 20-day-old baby was rushed to the emergency room at the Children’s Hospital of Philadelphia after being in a car crash. The baby had been riding in a car seat in the passenger side of a Ford Escort when it collided with another vehicle. The airbags deployed, killing the infant. The driver survived.

Flaura Koplin Winston, an associate professor of pediatrics at Penn, had just finished her residency and joined the faculty at Penn when the crash occurred. Soon afterwards, a second infant was brought into the ER with airbag injuries. And then a third, a three-year-old in a coma because of an airbag.

The tragedies, Winston says, made it clear that there was a need for a place where experts in all the different fields of child injury research could share their thoughts and findings. With that in mind, Winston founded the Center for Injury Research and Prevention at CHOP, knowing that injuries are the leading cause of death and acquired disability among youth.

Because injury is an interdisciplinary field by nature, the Center is interdisciplinary by design and includes experts from epidemiology, biostatistics, engineering, behavioral sciences, outreach, public policy and public heath. Preventing injuries to children is a complex problem requiring a number of different scientific approaches, says Dennis R. Durbin, an associate professor of pediatrics and epidemiology at Penn and co-scientific director of the Center.

In 1998, the Center partnered with State Farm Insurance to form Partners for Child Passenger Safety, the world’s largest child-focused motor vehicle crash surveillance system. One of the study’s first research findings showed that the vast majority of children over the age of four were not using child restraints, putting them at risk for injury or death.

So the Center set out to change the norms to make the use of booster and carseats routine. They made sure adults participating in the study had access to seats and felt comfortable using them, and disseminated information to the media to inform the general public about the safety issues.

Their efforts paid off. As of 2007, Winston says the vast majority of children in the U.S. through age eight are either using booster or car seats. All told, the Center has been involved in upgrading 48 state laws and two federal laws concerning booster seats. The Center has also created a website in English and Spanish (www.chop.edu/carseat), offering child traffic safety information.

The Center’s largest program, the Young Driver Research Initiative, is a collaboration between Penn, CHOP and State Farm. Durbin says the initiative is designed to understand the causes of young-driver crashes and devise effective interventions for teens, parents, schools and communities. These days much of the concern centers on cell phone use in cars and texting while driving.

“There is evidence that if you are on a cell phone, no matter if it’s hands-free or not hands-free, it increases your risk of crashing,” Winston says. She adds that one of the major concerns about child traffic injuries in the United States is that Americans do not yet prioritize safe driving and injury prevention. When Americans think about traffic injury prevention, she says, they think about lives saved in emergency rooms.

For example, Winston says, most Americans don’t realize that if they take their eyes off the road for two seconds out of any given six seconds, their risk of crashing increases significantly. “You have two seconds from the time that you detect a hazard to actually avoiding a crash,” she says. “If you are tailgating or you’re tired and your reaction time is slowed, it makes it even less.”

Both Winston and Durbin are parents of driving-age children. Durbin’s daughter is approaching her Sweet 16. “I will experience firsthand the challenges of trying to teach her how to be a safe and responsible driver,” he says. “I’m looking forward to having my own personal experience inform the work that we do.”

Winston has a 15-year-old and a 20-year-old. She stresses no talking on cell phones or texting while driving. She eased her 20-year-old into driving, giving him progressive increases in privileges as he demonstrated responsibility.

Over the next decade, Winston says she would like to see teen driving safety become the norm.

“Look at what happened with booster seats,” she says. “It’s the norm now. It was not 10 years ago. You were the safety-crazy parent if your child was in a booster seat. So my hope is 10 years from now, parents and teens and anybody who cares about adolescents will consider crash and injury prevention to be in the top four priorities for teens.”

Originally published on January 7, 2010