Basics of Child Passenger Safety in North Carolina Prepared by: Highway Safety Research Center University of North Carolina November 2005

Basics of Child Passenger Safety NC Occupant Restraint Laws The Need for Child Restraints and NC Occupant Restraint Laws

The Need for Child Restraints Children are not miniature adults Need special restraints Infant's head larger and heavier - Legs are shorter Newborn's shoulders are narrow and flexible Child's pelvis is small, rounded and not fully developed until puberty.

The Need for Child Restraints Child restraints (CRs) work with belts to Prevent ejection Distribute and load crash forces to the strongest parts of the body. CR must be properly used to be able to do this Occupant restraint systems can not promise complete crash protection, but CRs about 70% effective in reducing fatalities and serious injuries Lap & shoulder belts plus frontal air bags about 50 - 60% effective

NC Has 3 Occupant Restraint Laws CPS Law Seat Belt Law Children in Back of Pickup Trucks

NC CPS Law G.S. 20-137.1 - Effective January 1, 2005 Requirements Covers children < age 16 in any seating position Properly used CR/Booster required if less than age 8 AND less than 80 pounds Properly used seat belt allowed at age 8 OR 80 lbs., whichever comes first If no lap and shoulder belt is available for a booster, a child weighing at least 40 pounds may be restrained by a properly fitted lap belt only.

NC CPS Law Requirements (continued) Must be in rear seat if Child is less than age 5 and less than 40 lbs. Vehicle has active passenger side front air bag Vehicle has a rear seat Front allowed if the CR is air bag compatible

NC CPS Law Exemptions Were included in earliest version of the law Ambulances & other emergency vehicles Tending to personal needs More kids than available belts Vehicles not required to have belts Were included in earliest version of the law Helped get a law Not considered to be safe or recommended practices

NC CPS Law Penalties Driver is responsible (even if not parent) Maximum $25 fine Full court costs (~$110) 2 driver license points No insurance points Charges to be dropped if Child < 8 and < 80 lbs. and CR has been acquired for vehicle child is routinely transported in

NC CPS Law No organizations are exempt from the NC CPS Law, only types of vehicles Includes public and private schools, child care centers, churches, camps. etc If vehicle is covered CPS law applies May be subject to additional regulations If vehicle is exempt NC CPS law does not apply

NC Seat Belt Law G.S. 20-135.2A Requirements Covers driver and front passengers older than age 15 (16+) Properly used seat belt Passenger motor vehicle in forward motion on street or highway

NC Seat Belt Law Exemptions (generally not considered to be safe) Medical, physical, mental conditions Rural letter newspaper carriers “Door to door” deliveries Commercial/farm plates when being used for business Vehicles not required to have belts Penalties $25.00 fine $75.00 court costs (not subject to full cost of court) No driver's license points No insurance points

NC Children in Pickup Trucks Law G.S. 20-135.2B Requirements Covers children less than age 12 Prohibited from riding in an open bed or open cargo area without permanent overhead restraining construction No definition for “permanent overhead restraining construction”

NC Children in Pickup Trucks Law Exemptions (generally not considered to be safe) Adult present and supervising the child Child restrained by a seat belt An emergency situation exists In a parade pursuant to a valid permit Agricultural enterprise The vehicle is being operated in a county that has no incorporated area with a population in excess of 3,500

NC Children in Pickup Trucks Law : Exempt Counties Alexander, Alleghany, Ashe, Avery, Bertie, Camden, Caswell, Cherokee, Clay, Currituck, Duplin, Franklin, Gates, Graham, Green, Hyde, Jackson, Jones, Macon, Madison, Mitchell, Montgomery, Northhampton, Pamlico, Pender, Perquimans, Polk, Swain, Tyrrell, Warren, Yadkin, and Yancey Alexander Mitchell Cherokee Graham Clay Alleghany Swain Jackson Madison Polk Yancey Macon Avery Ashe Yadkin Montgomery Jones Duplin Greene Northampton Caswell Franklin Warren Pender Pamlico Currituck Bertie Gates Tyrrell Camden Perquimans Hyde Exempt Counties

NC Children in Pickup Trucks Law Penalties: Maximum $25 fine No court costs No license points No insurance points

Legal vs Recommended Legal Recommended Sets minimum standards Laws are based mostly on age Not required that all occupants be buckled up at all times in all positions Recommended Provides maximum protection Best restraints to use also based on weight and physical development EVERYONE should be properly restrained in all seating positions at all times

HOW RESTRAINTS PROTECT OCCUPANTS IN CRASHES Basics of Child Passenger Safety HOW RESTRAINTS PROTECT OCCUPANTS IN CRASHES

What Happens in a Crash: Basics of Crash Dynamics Dealing with laws of physics and motion: Object in motion will remain in motion... Occupant moves toward point of impact until stopped by another object Could be protective system (safety belts or child restraint), or Could be hostile object Courtesy Insurance Institute For Highway Safety

Basics of Crash Dynamics Weight times speed is an approximation of impact force

Three Collisions In A Crash 1. Vehicle collision 2. Human collision 3. Internal collision 3rd 2nd 1st

Five Ways Restraints Reduce Injury 1. Prevent ejection - If ejected: 4 times more likely to be killed 14 times as likely to sustain cervical spine injury 2. Load forces on strongest parts of the body Older child or adult = Hips and shoulders Infant and young child = Hips, shoulders and back 3. Spread forces over wide area Belts/Harnesses = Over shoulders, chest & hips Rear-facing CR = Over back, neck and head

Five Ways Restraints Reduce Injury 4. Allow the body to slow down gradually Vehicles crush in a controlled manner Can take advantage of vehicle ride down only if a "part" of the vehicle via safety belt or CR 5. Protect the head, neck, and spine Shoulder belt/CR harness keeps head/upper body away from hostile surfaces of the vehicle Rear facing CR supports the head and neck

Three-Part Process for Correct Use Essential for Maximum Protection Restraint selection - Type of restraint, child restraint (CR), booster seat or seat belt, used must be appropriate for the age and size of the child 2) Securing the child in the restraint - The child must be correctly and snugly secured within the restraint itself 3) Installing the CR in vehicle – CR must be correctly and snugly secured in the vehicle by a tight and locked seat belt

Choosing The "Best" Child Restraint Basics of Child Passenger Safety Choosing The "Best" Child Restraint

"What is the best car seat for my child?" Common question, but no simple answer

NHTSA’s 4 Steps for Kids Infants: Rear-facing Toddlers: Forward-Facing with Harness Boosters Safety Belts

There Is No "Best” Car Seat For A Child “Best” CR Fits the child Fits the vehicle(s) Will be used correctly every ride Least expensive meets same standards as most expensive

Rear Facing Restraints Rear-facing Only Rear-facing Only Most convenient Fits small infants well Rear-facing convertible Can be used RF longer Rear-facing CR until at least age one and at least 20 pounds. Development of neck bones and ligaments Rear-facing best for any body of any size AAP recommendation Rear-facing Convertible

Front Facing Restraints Front-facing Convertible Front-facing convertible At least 1 year old AND at least 20 pounds Until harness outgrown – most at 40 lbs Front-facing only CR with harness Can Not be used for child less than 1 year old or less than 20 pounds Some can be used as a booster >40 pounds Front-facing Only

Front Facing Only - Integrated Child restraints built into a vehicle seat Some convert to a belt-positioning booster Some have 5-point harness up to 40-60 pounds

Front Facing Only - Harness/Vest E-Z-On Products Many different styles and sizes OK for lap belt only position for child > 40 lbs Require top tethers Travel vests For children 25-40 lbs Rigid back No tether E-Z-On Y Harness Cosco Travel Vest

Front Facing Only – Booster Seats When harness is outgrown (usually about 40 lbs.) Until both the lap and shoulder belts fit correctly High back booster Added whiplash protection Backless booster Light weight, easy to store Generally less expensive Incorrect Belt Fit Correct Belt Fit with Belt Positioning Booster

Safety Belts – Do Not Use Until: Child can sit all the way back in seat Child's knees bend comfortably over edge of seat Shoulder belt crosses shoulder between neck and arm Lap belt touches thighs Child will stay seated like this for whole trip

Safety Belts – Common Misuse Never tuck the shoulder belt under the arm or behind the back Illegal DANGEROUS! NO! NO!

Safety Belts – Aftermarket Accessories NO current federal standard for testing or regulation Provides illusion of added safety May move belt too high on abdomen NO!

Safety Belts – Primary Risks of Lap Belts Does not restrain the upper body Impact with vehicle interior likely Can "submarine" under belt if too loose Belt-induced injuries – “Seat belt syndrome” Injuries to the lower spine and organs such as spleen, liver and intestines Results from belt too high or too loose 3 year old in a 30 MPH frontal crash test

Seat Belt Syndrome Spinal cord or soft tissue damage due to Improper placement of lap belt over the abdomen Lap belt that rides up onto abdomen

Special Needs Restraints Use conventional restraints when possible Behavioral, medical or positioning needs may make specialized restraints necessary Low birth weight most common “special need”

Summary of Restraint Selection Recommendations Rear-facing (RF) Until at least 1 year of age and at least 20 lbs. RF convertible needed for most Infants AAP recommends rear facing until maximum allowed RF weight for convertible is reached Front-facing (FF) Children over age 1 and at least 20 lbs. In a FF convertible or other full harness type child restraint until the harness is outgrown

Summary of Restraint Selection Recommendations Belt-positioning booster seat After full harness child restraint is outgrown Use booster until Safety belt fits correctly and Child is mature enough Safety belt fits correctly when: Child's bottom is against the back of the seat, Knees bend at the edge of the seat cushion, Lap belt fits low and tight across the upper thighs Shoulder belt crosses the collar bone and chest

HARNESSING CHILDREN CORRECTLY IN CHILD RESTRAINTS Basics of Child Passenger Safety HARNESSING CHILDREN CORRECTLY IN CHILD RESTRAINTS

Harnessing Children Correctly In Child Restraints Function of Harness Reduces ejection Reduces contact with vehicle & other occupants Distributes forces over widest area of body Loads forces on strongest parts

Types of Harnesses Three-point Harness Five-point harness Harness-Shield Combination T-shield Tray-shield Shield Only

How Tight Is Tight Enough? No slack Pinch test Not so tight as to press into the child's body Retainer clips Keeps the straps on the child's shoulders Not required on all CRs If required with CR, position about armpit level

Rear-Facing Infant And Convertible CRs In general: Slot at or below the shoulders - or in the lowest slot If needed: Crotch roll Rolled around head and/or sides

Rear-Facing Infant And Convertible CRs Recline angle Upright enough for crash protection but not so upright that the child's head falls forward toward the chest Ranges from 30 - 45 degrees Older children better able to tolerate more upright

Securing the Harness for Forward-Facing Convertibles Straps threaded as specified by manufacturer Upper slots for most models Lower slots only if allowed by manufacturer Retainer clip about armpit level if needed Crotch strap Refer to instructions Adjust for proper positioning

Securing the Harness for Forward-Facing Only CRs Straps threaded as specified by manufacturer - at or above shoulders for most models Retainer clip about armpit level if needed Crotch strap Refer to instructions Adjust for proper positioning

INSTALLATION OF CHILD RESTRAINTS IN VEHICLES Basics of Child Passenger Safety INSTALLATION OF CHILD RESTRAINTS IN VEHICLES

Basic Elements of Installation Correct forward versus rear facing orientation Correct recline angle Safest position in the vehicle Correct belt path or LATCH anchors used Tight and locked seatbelt or LATCH system.

Safest Position In Vehicle Front seat or back seat? In general, back seat is safer and center rear is safest Rear and/or center not always possible Is there a passenger air bag? Never place a rear-facing CR in front of an active air bag 12 and under in the back seat If child must sit in front of air bag Proper upper and lower body restraint Adequate distance from dash Behaviorally mature

Child Restraints and Frontal Air Bags Infants in rear-facing CRs at high risk in front of an air bag Recommendations to minimize risk Children 12 and under in the back seat Rear-facing CRs must not be in front of active air bag Forward-facing CRs may or may not be allowed On/off switches allowed if MUST use front seat

Child Restraints and Side Air Bags Protect adults in side impacts Concerns for anyone, especially children, leaning/sleeping against side bags Dangers vary among different designs and vary from vehicle to vehicle Refer to vehicle owner's manual and CR instructions May be disabled since not required by federal standards

Safest Position In Vehicle – Other Considerations Which type of safety belt and/or LATCH system is present? Other features, e.g. deep "buckets" or large humps How do needs of each child relate to needs of other occupants?

Correct Forward- Or Rear-Facing Orientation Of CR Face rear until at least 1 year of age and at least 20 pounds Remain rear facing to maximum weight of CR for optimal protection In general, carry handles down

Correct Recline Angle Compromise between recline needed to maintain an open airway, and maximum crash protection May need correction for steeply sloped vehicle seat Front-facing recline - any designated positions are OK

Correct Belt Path / LATCH Anchors CRs engineered and tested with one or more designated safety belt routing paths Failure to follow instructions Will reduce effectiveness and Can lead to catastrophic failure WRONG: Incorrect belt path

Tight and Locked Safety Belt or LATCH System Lap belt (or lap belt portion of lap and shoulder combination) is what holds CRS Lap belt must stay tight and locked at all times Some safety belt systems cannot be used “as is” and need a fix

Belts that Need a Locking Clip Continuous loop lap & shoulder belt, and Retractor that only locks up in a crash or sudden stop, and Webbing slides freely though latch plate Must be installed near latch plate and buckle

“How tight is tight enough?” No more than 1” front to back and side to side Tested at belt path Can be achieved without Causing damage to the vehicle or CR Brute force

Function of Tethers Strap attached near top of forward-facing CR Reduces forward movement and rotation Can also fix some situations of incompatibility between CR and vehicle

Use of Tethers Designated tether anchor points in most US cars since 1986 Check vehicle manual for tether anchor location Obtain anchor hardware from vehicle dealership Most vehicles mfg. since Sept. ‘02 have “ready-to-use” anchors as part of LATCH

Lower Anchors and Tethers for CHildren LATCH FMVSS 225 Lower Anchors and Tethers for CHildren All passenger vehicles and CRs manufactured since September 2002 required to have LATCH

LATCH in the Vehicle At least two rear seating positions are required to be equipped with the complete LATCH system: 2 lower anchors and 1 upper tether anchor A third rear position is required to have tether anchor

LATCH on the Child Restraint Lower anchors hook to or snap on lower anchor bars in vehicle CR's can use either flexible or rigid anchor CR tether strap attaches to vehicle tether anchor

CHILD RESTRAINT MISUSES Basics of Child Passenger Safety CHILD RESTRAINT MISUSES

Importance of Correct Use CRs are most effective restraint available 70% effectiveness for properly used CRs for infants 50%-60% for older children 40%-50% effectiveness for adults in lap and shoulder belt combinations Misuse can Greatly reduce effectiveness of CR Be worse than no restraint at all

Consequences of Loose Installation

Consequences of Multiple Misuses (Loose installation, Harnesses in wrong slots (low), Retainer clip too low)

CPS PROGRAMS AND SERVICES Basics of Child Passenger Safety CPS PROGRAMS AND SERVICES

CPS Programs and Services CPS Clinics Permanent Checking Stations Child Restraint Distribution Programs

NC CPS RESOURCES NC Governor's Highway Safety Program (GHSP) Overall NC highway safety programs coordinator Primary source for NC specific traffic safety related materials and funding Coordinates Click It or Ticket and Booze It and Lose It www.ncdot.org/secretary/ghsp/ 800-999-9676 or 919-733-3083

NC CPS RESOURCES NC Department of Insurance Office of State Fire Marshal (OSFM) NC SAFE KIDS Buckle Up NC SAFE KIDS Buckle Bear Risk Watch www.ncsafekids.org 800-634-7854 or 919-661-5880

NC CPS RESOURCES University of North Carolina Highway Safety Research Center (HSRC) CPS Resource Center Coordination of NC CPS training Technical assistance to CPS advocates and educators Information for parents and care givers www. buckleupnc.org www.hsrc.unc.edu 800-672-4527 or 919-962-2202

Supplemental Slides

Basics of Child Passenger Safety Transportation of Children by Schools, Child Care Centers, and Other Organizations

Transportation of Children by Schools, Child Care Centers, Churches, etc No type of organization is exempt from the NC CPS Law, only types of vehicles. If vehicle is covered CPS law applies May be subject to additional regulations If vehicle is exempt NC CPS law does not apply

Transporting Children in 15-Passenger Vans Vans are required to have belts in all seating positions Are covered by NC CPS Law Organizations using vans must comply Regulations may prohibit use of vans

Transporting Children in 15-Passenger Vans Children <40 lbs. Harness restraints in lap-belt-only positions Children 8+ years old OR 80+ lbs Properly fitted lap and shoulder belts Children <8 AND <80 lbs In remaining lap and shoulder positions in belt positioning boosters. Children 40+ lbs In any remaining lap-belt-only positions using lap belt only DO NOT use belt-positioning booster seats in lap-belt-only positions

Transporting Children in Large School Buses Federal standards do not require seat belts on buses >10,000 lbs Large buses are exempt from the NC CPS Law. Includes school, activity, municipal transit, and charter buses School buses are safest vehicles Protect occupants by size, construction, and "compartmentalization" Safer than parents’ cars, vans, SUVs and other personal vehicles.

Transporting Children in Small School Buses Seat belts are required on buses 10,000 lbs or less Mostly lap-belt-only seat belts

Transporting Children in Small School Buses Seat belts are required on buses 10,000 lbs or less Mostly lap-belt-only seat belts Covered under the NC CPS law Children <40 lbs required to be in a child restraint appropriate for their weight Children 40+ lbs may be restrained by just the lap belt Belt-positioning booster seats must NEVER be used with just a lap belt.

Recommendations for Transporting Pre-School Children on School Buses Use of vehicles built to school bus standards for transporting pre-school and school children recommended by NTSB NHTSA Use of 12 to15-passenger vans could result in increased liability in the event of a crash Fatal van crash investigated by National Transportation Safety Board

NHTSA Recommendations for Transporting Pre-School Children on School Buses Preschool age children best transported in child restraints even on the larger school buses Must assure bus seat is seat belt ready Integrated child restraints are available

Additional State and Federal Regulations Federal regulations do not prohibit the use of vans by schools But do require any van (with a capacity of more than 10) sold or leased for use as a school bus to meet the safety standards applicable to school buses

Head Start Head Start regulations require using school buses or “allowable alternate vehicles” Designed for carrying 11+ people, including the driver Meets all school bus standards except those related to flashing lights and stop arms Children <50 pounds must be in child restraints while the buses are in motion

NC Child Care Regulations (NCAC 09 .1001) All adults and children must be buckled Only one person per seat belt or child restraint Children not allowed in front seat if operational passenger airbag present Children <2 must always be transported in a child restraint In large buses: Must retrofit bus with belts to install CR if not already equipped with belts Children age 2 and older exempt and may be unrestrained

Summary of Legal Requirements and Recommendations for ANY VEHICLE: Lap and shoulder belt positions: Required/Allowed: CR’s with harnesses if <40 lbs Belt positioning boosters if <8 years and <80 lbs Lap and shoulder belt if at least 8 or 80 lbs RECOMMENDATION: Continue to use booster seats until both the lap and shoulder belts fit correctly on the child

Summary of Legal Requirements and Recommendations for ANY VEHICLE: Lap belt only positions (with no lap and shoulder belted positions available) Required/Allowed CR’s with harnesses if <40 lbs Lap-only seat belts if 40+ lbs RECOMMENDATION if 40+ lbs Restraints with harnesses certified over 40 lbs Harnesses of various types certified over 40 lbs Retrofit shoulder belt kit + booster possibility for some older cars and vans

Child Passenger Safety in School Buses Basics of Child Passenger Safety Child Passenger Safety in School Buses

School Bus Safety Issues Statistically the safest transportation Larger & heavier Lower risk travel Conspicuous Meets stringent FMVSSs

School Bus Safety Issues Safer than cars Only .2 percent of fatal crashes Occupant protection features: Compartmentalization Safety belts: required on small buses Installed on all new buses in some states Requirements for use varies

School Bus Safety Issues Compartmentalization 20 in. min 24 in. max SRP

NHTSA School Bus Safety Recommendations Guidelines for Safe Transportation of Pre-School Age Children in School Buses Recent NHTSA testing re: transport of preschoolers in CRS Easiest to use small buses with belts Integrated CRS seats available Retrofit lap belts only as manufacturers recommend

School Bus Safety Occupant Protection Requirements Large buses >10,000 pounds Compartmentalization required Check with manufacturer for belt retrofits Integrated CRSs Small buses <10,000 pounds Safety belts required Lower LATCH anchors required in at least 2 seating positions (but tether anchors not required in school buses) Easier to install CRSs

Choosing The "Best" Child Restraint Supplemental Slides Basics of Child Passenger Safety Choosing The "Best" Child Restraint Supplemental Slides

Rear-Facing Only Birth to 17-22 lbs Facing the rear ONLY Good fit for small infants 3-point or 5-point harness Many with detachable bases May outgrow in length before weight - head within inch of top

Convertible Birth/5 lbs. to 40 lbs. Rear-facing - up to 20-35 lbs. Forward-facing - usually 22-40 lbs. May outgrow in height before weight Rear-facing - head within inch of top Forward-facing - top of ears above top of shell

Convertible Three types of harnesses T-shields and tray-shields are not recommended for small infants 5 Point Harness Tray Shield T Shield

Forward-Facing Only 20-22 pounds up to 40+ lbs Can ONLY be used facing to the front Recommended only for >1 AND >20 lbs May not be as comfortable as FF convertible

Forward-Facing With Harness Most to 40 pounds May go as high as 80 Britax Expressway 20-40 lbs. Britax Husky 22-80 lbs.

Correct Belt Fit with Belt Positioning Booster Provides transition from CRs with harness to vehicle lap/shoulder belts Minimum weight ranges 30-40 lbs Maximum weight ranges 60-100 lbs Maximum height limits vary Incorrect Belt Fit Correct Belt Fit with Belt Positioning Booster

Booster Two types of booster seats: Shield Booster: Belt-Positioning Booster (BPB) High back Backless Removable Shield Backless High Back

Combination Child Restraint/Booster Internal harness 20 to 40 pounds Modified for use as a BPB > 40 lbs May not be as suitable as FF convertible for smaller children

Transporting Children with Disabilities and Special Needs Basics of Child Passenger Safety Transporting Children with Disabilities and Special Needs

Children with Disabilities and Special Needs CRS selection should be determined by health professional and IEP team Conventional CRS may be appropriate Specialty devices are generally more expensive More difficult to access and use CPS Technician can install and advise Wheelchairs should be last resort and only crash tested models with voluntary compliance label should be used

Children with Disabilities and Special Needs Main classifications: Respiratory Conditions Low Birth Weight Orthopedic Conditions Neuromuscular Conditions Behavioral Conditions

Securing Child In Car Bed For small, premature, or medically fragile who should ride flat Infant lies prone/supine Head placed toward the center of the vehicle

Children with Disabilities & Special Needs Orthopedic Conditions Seat for Hip Spica Cast E-Z-On Modified Vest for full body cast

Children with Disabilities & Special Needs Neuromuscular Conditions Provides additional upper body restraint and positioning for higher weights

“Normal” Behavioral Issues There are no “childproof” seats. Switching seats is not the answer to normal behavioral problems Parent must be in charge and limit choices Firmness and consistency are key to reducing and correcting problems Effort expended is worth the benefits of long-term behavioral training Babies become TEENAGERS!!! Train early for less worry then

E-Z-On Vest with back zipper closure Behavioral Disorders May need safety devices that they cannot get out of themselves E-Z-On Vest with back zipper closure

Auxiliary equipment Required auxiliary equipment (e.g., oxygen tanks and monitors) must be secured No single product/method available Recommendations include Wedging the equipment on the vehicle floor with pillows Securing it with bungee cords or seat belts not being used by a passenger.

CHILD RESTRAINT MISUSES Supplemental Slides Basics of Child Passenger Safety CHILD RESTRAINT MISUSES Supplemental Slides

Reasons for Misuse Human Factors Failure to read instructions Inability to understand confusing instructions Choosing the "convenient way" Misuse - 3

Reasons for Misuse Equipment Many combinations of belts, CRs and vehicle configurations create incompatibilities CR instructions may conflict with vehicle’s instructions Lack of instructions Used seats are often missing parts, instructions, and labels Misuse -4

Types of Misuse: Gross Misuse Misuse that makes restraint virtually useless - likely to result in serious injury or death CR not secured to vehicle at all Child not harnessed in CR Infant < 20 lbs. or < age 1 facing front RF CR in front of air bag RF-only CR used facing front

Types of Misuse: Other Misuses Many ways misuses reduce effectiveness of CRs Can be related to selection, harnessing, or installation If it can be done it WILL be done! Multiple misuses compound and become a serious danger to the child Misuse - 6

Restraint Selection Errors Inappropriate restraint selection Recalled CR not repaired CR damaged or not working correctly WRONG: Household “carrier”, not a CRD

WRONG: Harness too loose, not on shoulder, retainer too low Harnessing Errors Straps in wrong slot Harness not placed on child correctly Too loose Adjustment mechanism not locked Retainer clip too high or too low Frayed, twisted, pinned, knotted or damaged webbing WRONG: Harness too loose, not on shoulder, retainer too low

WRONG: Rear-facing only CR facing front Installation Errors Safety belt not locked Safety belt locked but too loose CR installed in wrong direction Incorrect recline angle WRONG: Rear-facing only CR facing front

WRONG: Incorrect belt path Installation Errors Safety belt through wrong belt path Locking clip not used or used incorrectly No tether used if required or incorrect use of tether system WRONG: Incorrect belt path

WRONG: Shoulder belt under arm Misuse of Safety Belts Lap belt too high leads to internal injuries Shoulder belt too loose allows too much upper body movement Shoulder belt under the arm Too much upper body movement Can result in internal injuries Shoulder belt behind the back Provides no upper body protection Does not work as well as does a lap belt only Any misused seatbelt is especially dangerous in front of an air bag WRONG: Shoulder belt under arm