Of the 2784 deaths on US air carriers from 1982 through 2001, 832 (30%) occurred as a result of crashes in which there were survivors, 8 so we used 30% as our estimate. For simplicity, we defined a survivable crash as any crash in which there were survivors. First we estimated the proportion of fatalities that occur in survivable crashes. We estimated in 2 steps the number of deaths of children younger than 2 years that might be prevented by CRS use. Inputs for Calculations of Potential Numbers of Deaths Prevented by Reduced Air Fatalities and Caused by Diversion to Ground Travel We were specifically interested in how many young child air crash deaths might be prevented, the threshold proportion of families switching from air to car travel above which the projected harms of the policy would exceed its projected benefits, and how little the extra seats for young children would have to cost for the policy to approach the cost-effectiveness of other available injury prevention interventions. 4 The American Academy of Pediatrics committee acknowledged the FAA's previous concern that parents might opt to drive rather than pay for tickets for their young children but dismissed this possibility, stating "no data support this argument." 4 The committee also did not present any analyses of the numbers of lives that might be saved by the policy or the policy's costs.īecause we disagree with the American Academy of Pediatrics committee's assertion that no data support the FAA's concern about travel substitution 2, 5 and believe that analyses of benefits and costs can inform policy decisions like this one, we estimated the possible benefits, risks, and costs of the proposed policy by using a range of values for key unknown variables. 1, 3 Since their 2000 meeting, a regulation mandating CRS use for young children on airplanes has been on the National Transportation Safety Board's list of "Most Wanted Transportation Safety Improvements." 1 Recently, the American Academy of Pediatrics Committee on Injury and Poison Prevention released a policy statement recommending a federal requirement for CRS use on airplanes for all children younger than 2 years. The FAA's 1995 analysis was not accepted by the US National Transportation Safety Board, which argued that the FAA's estimates of diversion of travel from airplanes to cars were too high. This proposed regulation represents a policy change on the part of the FAA, which argued in a 1995 report to Congress that CRSs on aircraft would prevent a maximum of 5 child plane crash deaths per 10 years and would result in a net increase of 82 deaths per 10 years because of families shifting to other, less safe modes of travel. 1 As a consequence, children younger than 2 years would no longer be able to travel on their parents' laps but would require a seat of their own, with the costs passed on to their parents, other passengers, or the airlines' shareholders. THE US FEDERAL Aviation Administration (FAA) will soon propose a regulation mandating use of child-restraint systems (CRSs) for all children flying in aircraft. Even excluding this possibility, the cost of the proposed policy per death prevented is high. Assuming no increase in car travel, for each dollar increase in the cost of implementing the regulation per round trip per family, the cost per death prevented would increase by about $6.4 million.Ĭonclusions Unless space for young children in restraint seats can be provided at low cost to families, with little or no diversion to automobile travel, a policy requiring restraint seat use could cause a net increase in deaths.
#Child restraint systems on airplane driver#
The estimate for this proportion varied with assumptions about trip distance, driver characteristics, and the effectiveness of child-restraint seats but is unlikely to exceed 15%. Increased deaths as a result of car travel could exceed deaths prevented by restraint seat use if the proportion of families switching from air to car travel exceeded about 5% to 10%. Results Child-restraint seat use could prevent about 0.4 child air crash deaths per year in the United States. Objectives To estimate the annual number of child air crash deaths that might be prevented by the proposed regulation, the threshold proportion of families switching from air to car travel above which the risks of the policy would exceed its benefits, and the cost per death prevented. Shared Decision Making and CommunicationĬontext The US Federal Aviation Administration is planning a new regulation requiring children younger than 2 years to ride in approved child-restraint seats on airplanes.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.
Challenges in Clinical Electrocardiography.
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