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Restrained children between the ages of 3 to 15 years in crashes were identified in an on-going crash surveillance system (1998-2002) which links insurance claims data to telephone survey and crash investigation data. The risk of upper extremity injury associated with airbag deployment was estimated and a series of cases was examined using in-depth crash investigation to identify the mechanisms of these injuries. This study found that 3.5% of children who were exposed to a passenger airbag (PAB) received an upper extremity fracture, making them 2.5 times as likely to sustain an upper extremity fracture than children in similar crashes who were not exposed to a PAB. Female children were 2.2 times as likely to receive an isolated upper extremity fracture when exposed to a PAB than male children. The incidence rate, gender difference, and injury mechanism in children all appear to be similar to those of adults.

Data presented in this paper demonstrated that the landscape for child occupant protection - the children and their restraints, vehicles, and crashes - is changing rapidly. Children are not small adults but are rather rapidly growing, developing, and changing and so too are their restraint needs. The past several years witnessed a growing awareness of these biomechanical challenges with the emergence of increased use of size-appropriate restraints for children under age 9 years and differences in patterns of injury by age. Vehicles involved in crashes with children reflect the trend overall: less passenger vans and cars and more light trucks, the majority of which are equipped with second generation air bags. The majority of crashes occurred on roads with posted speed limits below 45 miles per hour. The age group of particular concern is the newly driving teenage years (16-19) in which the crash and fatality rates are the highest among all age groups.