Statement on prevention of non-traffic vehicle-related injuries in children

The American College of Surgeons (ACS) Committee on Trauma (COT) Subcommittee on Injury Prevention and Control developed the following statement to support legislation that would improve safety measures for children in and around cars. With the help of the National Highway Traffic Safety Administration, new vehicle safety devices are being designed and implemented. These devices address back-over and blind spot accidents that lead to an increasing number of childhood injuries and deaths each year. The COT supports legislation and other efforts to increase the safety of children in and around cars. This statement was reviewed and approved by the ACS Board of Regents at its October 2015 meeting in Chicago, IL.

The ACS recognizes that injuries are the leading cause of death and disability in children, despite the fact that the means to prevent these injuries are readily available. In particular, the following data pertain to children who are injured by motor vehicles when they are left unattended in or around cars:

  • The not-in-traffic surveillance (NiTS) data show that in the four-year period spanning 2008 to 2011, non-traffic motor vehicle crashes killed an estimated 1,043 children ages 14 and younger. Additionally, an estimated 30,000 children of this age group were injured in these crashes.
  • In 2013, at least 180 children died in non-traffic vehicle-related incidents because adults left them unattended in or around a vehicle.
  • Approximately 24 percent of the deaths that occur in this situation result from children overheating while left in a car in hot weather.
  • More than 50 percent of the deaths are caused by a child being run over by a motor vehicle in the driveway or while the vehicle is backing up. In these incidents, the driver is usually a parent.
  • Most rollover/back-over injuries are due to larger, high-profile vehicles (such as trucks and sports utility vehicles) with increased morbidity and mortality.
  • In 10 percent of driveway fatalities, a child puts the car in motion.

In addition to educating parents about the dangers of leaving their children unattended in and around motor vehicles, the ACS endorses the following prevention activities:

  • Support of legislation that impose fines on parents/caregivers who leave children unattended inside vehicles
  • Furthering of research, development, and installation of “back-over prevention devices” and rearview cameras in trucks, minivans, and other large vehicles
  • Studies on the effectiveness of sensing devices that would sound an alarm when a child is left in a car seat and the key has been removed from the ignition
  • Further research on the effectiveness of devices that would prevent children from being able to start a vehicle


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Fenton SJ, Scaife ER, Meyers RL, Hansen KW, Firth SD: The prevalence of driveway back-over injuries in the era of sports utility vehicles. J Pediatr Surg. 2005;40(12):1964-1968. 2013. National statistics. Available at: Accessed November 23, 2015.

Nader EP, Courcoulas AP, Gardner ME, Ford HR. Driveway injuries in children: Risk factors, morbidity, and mortality. Pediatrics. 2001;108(2):326-328.

Patrick DA, Bensard DD, Moore EE, Partington MD, Karrer FM. Driveway crush injuries in young children: A highly lethal, devastating, and potentially preventable event. J Pediatr Surg. 1998;33(11):1712-1715.

Pinkney KA, Smith A, Mann C, et al: Risk of pediatric back-over injuries in residential driveways by vehicle type. Pediatr Emerg Care. 2006;22(6):402-407.

U.S. Department of Transportation. National Highway Traffic Safety Administration. Traffic Safety Facts. Not-in-traffic-surveillance: Child fatality and injury in nontraffic crashes, 2008 to 2011 statistics. Available at: Accessed November 6, 2015.

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