We often hear about traffic accidents on Malta’s roads but, thankfully, we rarely hear about children who are seriously injured.
But, even when there are accidents that involve minor injuries on children, no data is released to inform us on what went wrong.
“The child fatality rate is very low in Malta, so child safety in cars does not get much attention from parents, but we don’t know how many injuries go unreported in the news, let alone the impact of unsafe practices,” Rebecca Buttigieg, a mechanical engineer and accredited car seat adviser, says.
“Unfortunately, the Maltese authorities do not release any details when a child passenger is injured or killed in a car crash, regarding what car seat the child was in (or not in), and whether it was rear or forward facing, or correctly installed and used, so Maltese parents don’t have any local information to go on.”
She explains that according to a report commissioned by ANEC, a European consumer group, information from autopsy results of American three-year-old passengers who died forward-facing concluded that they would have survived if rear-facing. This is very powerful evidence for parents, she says.
“No one wants to shame parents whose child was injured or killed in a car crash, but perhaps if the Maltese authorities released anonymised data, that could help Maltese parents understand the risks to their children, and learn from the mistakes of others.”
Rear-facing car seats are safer
Buttigieg has long been advocating that parents should keep their children in rear-facing car seats. In Europe, parents can buy car seats that rear-face children up to six or seven years old.
So far, she adds, no forward-facing car seats have managed to provide enough protection to pass the strict Plus Test that is administered by the renowned Swedish National Road and Transport Research Institute (VTI).
“Although there is evidence for the safety of rear-facing a child in order to protect the neck and spinal cord, there does not seem to be any evidence to show that it is safe to forward-face a child from a particular age.
“Indeed, in military aircraft, the seats face backwards because rear-facing has been proven to be safer even for air travel. The idea has been tried in civilian cars, buses, trains and planes, and abandoned simply because most adults prefer to travel forward-facing even though it is less safe.”
Children in car seats − it’s the law
Buttigieg believes that the public’s lack of awareness goes beyond rear- or forward-facing car seat choices. Most parents in Malta don’t seem to know that children, by law, must use at least a booster cushion until they are 12 years old or 150cm tall, she says.
“This law exists because seat belts are designed for a minimum height of 145cm and are designed to place the car crash forces on the person’s pelvis and collarbone. If the seat belts don’t fit correctly, then instead the car crash forces will be placed on other areas of the body, where they can seriously injure a child. Yet it is very common to see Maltese children riding without any booster from a much younger age, because parents don’t know that the seatbelt placement is still unsafe.”
She adds that as from September 2024, only I-Size car seats will be legal to sell on the European market. I-Size sets a minimum height of 100cm for moving a child into a high-back booster seat that uses the car’s seat belt instead of a harness, and a minimum height of 125cm for moving a child onto a booster cushion that does not have a back or sides.
But, she cautions, a parent should base their decision on more than just centimetres.
“This law exists because seat belts are designed for a minimum height of 145cm”
“There is a risk that a child who is not emotionally mature enough will not sit correctly under a seat belt, which puts them at greater risk of injury in a crash, so it’s important not to rush moving a child from a harness car seat to a high-back booster seat,” she notes.
“Likewise, although many children will reach 125cm tall around the age of seven, a child on a booster cushion not only loses the side impact protection of their previous seat, they also need to remain upright without support, not leaning on the car door to rest or sleep, or leaning over to speak to others. So, although it’s legal at seven, the general recommendation is to wait until at least age eight or nine years old.”
She points out that if the car’s seat belt sits up on the child’s belly, then that is the biggest sign that the child is still too small to ride without a booster cushion: in a crash, that belt could cause severe internal injuries.
Likewise, the shoulder belt needs to touch and wrap over the child’s shoulder, which will not happen if the child is too short. If the shoulder belt is tucked under the child’s arm or behind the head because it’s too high, then that child is at greater risk of injury in a crash.
The safest spot in the car
All this gives parents a lot to think about: which is the safest spot in the car for a child?
According to Buttigieg, there is some debate regarding the safest spot in the car, and many people are surprised to find out that in Malta, as in most European countries, it is both legal and safe to have a child in the front seat (with the caveat that if the child is rear-facing, the airbag must be switched off for safety reasons). This is not legal in the US because their airbags are bigger and more powerful.
In modern cars especially, many safety features are concentrated on the front seat passengers, including safety features built into the dashboard, which can make the front seats as safe as, if not safer than, the back seats, she says.
“For parents who have an airbag switch for the front seat, and are trying to decide between the front seat or back seat for rear-facing babies or toddlers, it’s best to put the child where they will distract you the least − whether it’s from crying while in the back seat, or being so cute in the front seat that you’re tempted to look at them while you’re meant to be looking at the road.”
“Children in the front seat must still be in a car seat, booster seat or on a booster cushion until age 12 or 150cm”
For older children who are forward-facing, follow the instructions in your car’s instruction manual regarding the airbag: if the manufacturer says to have the airbag switched on for forward-facing children, then it is generally a good idea to avoid the front seat until the forward-facing child is at least 140cm tall (around age nine) because of the risk of injury from the airbag.
Of course, children in the front seat must still be in a car seat, booster seat or on a booster cushion until age 12 or 150cm, as per Maltese law. As with adult passengers, if a forward-facing child is riding in the front seat, it is important that they do not place their feet up on the dashboard, because if the airbag deploys and pushes their legs up to their head, this could cause severe injuries.
Buttigieg adds that most people are also surprised to find out that children in the back seat can break their legs, arms or necks when impacting the back of the front seat in a crash.
Regarding choosing between the back seats, the middle of the back seat is the farthest away from the impact if another car hits yours from the side, but in most cars used in Malta, this middle seat is not a full seat, and it’s often not possible to safely or securely install a car seat in the middle.
“There doesn’t seem to be a significant difference in risk from being hit on the right-hand side or the left-hand side of a car, so instead it’s good for parents to think about safety in terms of passengers getting in and out of the car. If the parent has two children in the back, the parent might want to place the older child on the left so that the older child can get in by themselves from the pavement, while the parent loads in the younger child from the side of the car that is exposed to traffic,” she says.
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