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Only 11% of children properly restrained in taxis
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BALTIMORE — Despite AAP guidelines, a significant proportion of children riding in taxis are not properly restrained in car safety seats, according to recent study findings presented at the Pediatric Academic Societies Meeting.
While the AAP recommends that children be secured by car safety seats or belt-positioning booster seats until they reach the height of 4’9”, several states have laws which exempt taxis from the car seat laws that apply to those driving in standard passenger vehicles.
Ruth Milanaik
“Given that car safety seats have been shown to significantly decrease the risk of death or injury from motor vehicle collisions, there should be no exemptions in car seat safety laws for taxi services,” Ruth Milanaik, DO, from the Cohen Children’s Medical Center in New Hyde Park, NY, said in a press release. “When it comes to child safety, even one preventable injury calls for a change in policy.”
To ascertain the use of car safety seats among children riding in taxis – and evaluate whether car safety seats were readily available through taxi companies – the researchers posted at 11 locations in the New York metropolitan area, observing passengers with small children as they embarked/disembarked from taxis. In their observation, Milanaik and colleagues noted the number of adult and child passengers, whether car safety seats were used and the demographics for all passengers.
The researchers then assessed availability of car safety seats among taxis via anonymous phone inquiries to taxi companies based in the New York metropolitan area, chosen from the top search results on an online directory.
According to study results, among 67 taxis observed with children (n=116), only 11% of the children were properly restrained, and these were almost entirely infants in infant carriers.
Among the taxi companies (n=97) in the New York area that were surveyed, the researchers found that 39% reported an availability of car safety seats. Of the taxis companies that did offer car safety seats, 18% noted that car safety seats were limited or required a reservation, and 8% mentioned that there would be an extra fee. When questioned about their policies for not providing car safety, other taxi companies stated reasons including health code restrictions, allergies and hygiene.
“Motor vehicle collisions are a leading cause of death among children in the United States,” principal investigator Tammy Pham told Infectious Diseases in Children. “While the exemption of taxis from occupant restraint laws provides convenience for taxi companies, as well as for parents traveling with small children, it nonetheless poses a risk for children who ride unrestrained by proper safety seats.”
Pham concluded, “We encourage changes in laws to require use of car safety seats in all motor vehicles, including taxis. To this end, taxi companies should make car safety seats available to child passengers, and parents should make sure to always secure their children in proper safety seats whenever traveling in a motor vehicle, even if the law does not yet mandate it.”– by Bob Stott
Reference:
Koffsky S, et al. Abstract 2873.575. Presented at: Pediatric Academic Societies Meeting; April 30-May 3, 2016; Baltimore.
Disclosure: The researchers reported no relevant financial disclosures.
Perspective
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Daniel M. Fein, MD
Everyone knows that when you have a child and you’re driving in a car, you need to have them in the appropriate child restraint system, whether this is a rear-facing car seat for children aged less than 2 years or a booster seat for older children. Laws vary by state, but the one common thread between all states is that you need to have your child in an appropriate child safety system; however, this is not so the case for taxis.
In this study, researchers surveyed 11 very busy centers in the New York metropolitan area and watched to see what was actually happening, without relying on any third-party recording. They found that only 11% of children were appropriated restrained in taxis. Furthermore, researchers called several taxi companies and found that about only 40% of them had child safety systems available and even then, there were limitations on it – you either had to reserve or even pay extra.
Working at the Children’s Hospital at Montefiore in the Bronx, this is an issue that is near and dear to my heart as many of our children who come and seek treatment arrive via taxi, so it’s not only that this puts them at risk in general, but that is how they are getting to the hospital in the first place. As the researchers highlight, motor vehicle collisions are a leading cause of death in children and the failure to ensure that children who commute via taxis are appropriately restrained puts them at risk for serious injury and death.
It is incumbent upon us, as emergency medicine physicians and the general pediatric community as a whole, to advocate for the safety of our children and to ensure that all 50 states have some sort of law in place across the board to protect our children when they are commuting via taxis. This will get even more complicated in the future as third-party driving companies like Uber and Lyft start to carry more passengers; there is a gray area that will need to be further defined as these laws get hashed out in local, state, and hopefully, national levels as well.
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