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Injuries From Bus Accidents Exceed Estimates

Nov 6, 2006 | Chicago Tribune

Children riding on school buses suffer about 17,000 injuries each year, far more than previous estimates, according to a new study that highlights a controversy over whether such buses should be outfitted with seat belts.

The results show that children ages 10 to 14 have the greatest chance of injury, suggesting that injury-prevention efforts should focus on that group.

School buses are still among the safest ways to travel, child-safety experts stressed. Accident rates for passenger vehicles taking children to or from school are far higher than the rate for school buses, according to the National Highway Traffic Safety Administration (NHTSA).

But the new report, published today in the journal Pediatrics, indicates that some risks on buses may have been overlooked.

For example, the authors found that only 42 percent of bus injuries that required emergency-room visits happened during a crash. Many of the rest occurred when students fell during sudden stops, or while getting on or off the bus.

"We don't want to make parents fearful of putting their children on a school bus," said Dr. Marilyn Bull, co-author of the study and a developmental pediatrician at Riley Hospital for Children in Indianapolis.

Still, "even we were surprised at how many injuries are actually reported," she said.

The outcome may not come as a surprise to bus drivers or to the children themselves.

Veteran Crystal Lake, Ill., bus driver Thomas Bramley has seen children slide off their seats into the aisle and bounce around like little balls with backpacks. And yet he says with certainty that his little charges are cocooned in one of the safest vehicles on the road.

"If we're braking hard or going around corners, if the kids are not in their seats correctly, yes, they can be bounced around or slip," Bramley said. "But for the amount of kids transported daily, the school bus has proved to be the safest transportation."

The relative safety of buses is clearest when it comes to fatal injuries. Federal estimates are that school buses account for 0.2 deaths per 100 million miles traveled, compared with 1.5 fatalities per million miles for passenger vehicles.

Yet previous studies missed many nonfatal bus injuries. In 2002 the Transportation Research Board of the National Academy of Sciences estimated that child passengers on school buses had just 5,500 injuries per year.

That previous estimate relied on a national database on vehicle crashes and would have excluded injuries on field trips that took place outside of school hours. The new study, led by epidemiologist Jennifer McGeehan of Columbus Children's Hospital in Ohio, drew from a different database containing information on emergency-room visits resulting from school-bus injuries from 2001 to 2003.

NHTSA, which sets standards for school buses, requires seat belts for buses under 10,000 pounds but not for larger buses, which are better able to absorb impacts.

The American Academy of Pediatrics recommends that all new school buses include seat belts. But experts say it's not obvious that the potential benefits warrant such a move.

In a 2002 report to Congress, NHTSA found that lap belts might cause more injuries than they would prevent. Children's heads could snap forward and strike the seat in front of them, raising the risk of neck injuries.

Installing three-point lap and shoulder belts would reduce the risk of injury, but the federal agency estimated that such a measure is likely to prevent just two fatalities each year nationwide. At the same time, the cost of putting such seat belts in all new buses sold nationwide would be up to $150 million each year.

Despite the expense and uncertain payoff, many parents and researchers say it simply feels right to install seat belts in an era when children are told that they must wear restraints in other vehicles.

"When they get in a bus and don't have to wear a seat belt, it's an uncomfortable feeling for many children," Bull said.

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