Beware the Rear Seat of Compact Extended-Cab Pickups
Beware the Rear Seat of Compact Extended-Cab Pickups
Abstract & Commentary
Source: Winston FK, et al. Risk of injury to child passengers in compact extended-cab pickup trucks. JAMA 2002;287:1147-1152.
The compact extended-cab pickup truck with a rear occupant compartment has grown in popularity during the past decade. Yet, little is known regarding the safety of children seated in this rear compartment as compared to rear row seating in other vehicles such as standard passenger cars, vans, sport utility vehicles (SUVs), and full-sized extended-cab pickup trucks.
In this cross-sectional study, researchers compared injury rates and risk for injuries in children age 15 years or younger who were passengers in compact extended-cab pickup trucks vs. other types of vehicles involved in motor vehicle crashes (MVCs). Data were obtained from a large-scale, child-specific, crash surveillance system involving insurance claims data identifying MVC incidents in 15 states.
A stratified cluster sampling of these incidents then was investigated further by means of a telephone survey of the vehicle occupants and an on-site crash investigation. Compact extended-cab pickup trucks were defined as pickup trucks with a second row of seats and a gross vehicle weight rating of fewer than 6000 lbs.
Overall, complete data were obtained on 7192 MVCs involving vehicles with two or more seating rows. There were 11,335 children at risk for injury in these MVCs. Children in compact extended-cab pickup trucks comprised 1.1% of the population. Injuries occurred in 7.5% of children in the compact extended-cab pickup truck, compared with 1.6% in other vehicles.
Adjusting for age, restraint use, point of impact, vehicle weight, and crash severity, children in compact extended-cab pickup trucks were at three times greater risk of injury than in other vehicles (odds ratio [OR] = 2.96). Moreover, seating position (rear vs front) had a significant interaction, as rear-seated children were more than four times as likely to be injured as those in rear seats of other vehicles (OR = 4.75). In comparison, there was only a trend toward increased risk of injury to children seated in the front row of compact extended-cab pickup trucks compared to other vehicles. In addition, when comparing compact vs. full-sized pickup trucks, children in the rear seat of a compact vehicle were at twice the risk of injury.
Based on their findings, the authors conclude that children seated in compact extended-cab pickup trucks are not as safe as children seated in other vehicles. The authors suggest that parents who have a choice should not transport their children in these vehicles.
Commentary by Theodore C. Chan, MD, FACEP
Rear-row seating of children in motor vehicles has long been encouraged to reduce the risk of crash injuries in this population. This study suggests, however, that such advice may not be appropriate for the popular compact extended-cab pickup truck.
These vehicles have small rear occupant compartments, often with side-facing, fold-down, or jump seats. The seats are considered auxiliary and are not subject to the same testing requirements for interior impact as other vehicles.1 In many instances, this rear compartment often has only two-point restraints and limited protective interior padding. In fact, researchers in this study found that contact with the vehicle interior contributed to the increased risk of injury to children in these vehicles.
The findings of this study are important to emergency physicians (EPs) for two reasons. First, EPs should be aware that children in such vehicles, particularly those seated in the rear, are at greater risk of significant injury requiring medical attention. Second, parents should be advised of the potential dangers of transporting children in the rear seat of these vehicles. In this study, 46% of children transported in compact extended-cab pickup trucks were in the rear seat. Parents and others should be advised that, unlike in other vehicles, the rear seat position may not be safer than the front seat in the compact extended-cab pickup truck.
Reference
1. U.S. Federal Motor Vehicle Safety Standard (FMVSS) 201, Occupant Protection in Interior Impact (49 CFR 571.201).
Dr. Chan, Associate Clinical Professor of Medicine, Emergency Medicine, University of California, San Diego, is on the Editorial Board of Emergency Medicine Alert.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.