American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Statement on Prevention of Nontraffic Vehicle-Related Injuries in Children

The following statement was developed by the Subcommittee on Injury Prevention and Control for the Committee on Trauma (COT) to support legislation that would improve safety measures for children in and around cars. Recently, with the help of the National Highway Traffic Safety Administration, the federal government passed legislation that requires all car manufacturers to meet safety standards for power windows that kill and injure hundreds of children each year. However, still pending is legislation that would address backovers and blindspots that are responsible for an increasing number of childhood injuries and deaths each year. The COT supports legislation and other efforts to increase the safety of children in and around cars. This statement was reviewed and approved by the Board of Regents at their February 2004 meeting.

The American College of Surgeons recognizes that injuries are the greatest cause of death and disability in children, despite the fact that the means to prevent these injuries are readily available. In particular, when children are left unattended in and around cars, the following facts pertain:

  • More than 9,000 children age 14 and younger are treated annually in emergency departments in the U.S. for injuries that occur when they are left unattended in and around motor vehicles.
  • In 2002, more than 100 children died in nontraffic vehicle-related incidents because adults left them unattended in or around a vehicle.
  • Approximately 27 percent of the deaths that occur in this situation result from children overheating while being left in a car in hot weather.
  • More than 50 percent of the deaths are caused by a child being run over by a motor vehicle that is backing up, and in these incidents, the driver is usually a parent.
  • In 20 percent of driveway fatalities, a child puts the car in motion.
  • The National Highway Traffic Safety Administration does not maintain a database for nontraffic, noncrash incidents and deaths.

In addition to educating parents about the dangers of leaving their children unattended around motor vehicles, the American College of Surgeons endorses the following prevention activities:

  • Supporting legislation that allows parents/caregivers to be fined for leaving children unattended inside vehicles.
  • Encouraging the National Highway Traffic Safety Administration to maintain a database for nontraffic vehicle-related incidents and fatalities.
  • Promoting the installation of "backover prevention devices" in trucks, minivans, and other large vehicles.
  • Studying the effectiveness of sensing devices that would sound an alarm when a child is left in a car seat and the key has been removed from the ignition.


Agran PF, Winn D, Castill D: Unsupervised children in vehicles: A risk for pediatric trauma. Pediatrics, 87:70-73, 1991.

Centers for Disease Control and Prevention: Injuries and Deaths among Children Left Unattended in or around Motor Vehicles. United States, July 2000-2001. 2002; 51.


Nader EP, Caeruleus AP, Gardner ME, Ford HR: Driveway injuries in children: Risk factors, morbidity, and mortality. Pediatrics, 108:326-328, 2002.

National Highway Traffic Safety Administration. NHTSA Pilot Study: Non-Traffic Motor Vehicle Safety Issues: An Examination of Selected 1997 Death Certificates and Related Activity. Technical Report. Washington, DC: U.S. Department of Transportation, 2002.

Patrick DA, Bensard EE, Moore EE, et al: Driveway crush injuries in young children: A highly lethal, devastating, and potentially preventable event. J Ped Surg, 33:1712-1715, 1998.

Reprinted from Bulletin of the American College of Surgeons
Vol.90, No. 1, January 2005