Physicians from an Ottawa children's hospital say school buses should be better padded to protect children during rollover-type crashes.
The recommendation comes after a child died following a collision between an Ottawa-area school bus and a pickup truck that caused the bus to roll over several times. Most of the 12 children on board, who ranged in age from 9 to 14, had only minor lacerations and contusions. However, 3 of the children sustained fractures, 1 received a cervical spine injury and an 11-year-old girl died because of a severe head injury.
Writing in the Canadian Journal of Surgery (2003;46:269-72), 3 specialists from the Children's Hospital of Eastern Ontario conclude that extra padding “would … minimize the number and severity of injury” in a rollover.
By assessing where the children were seated, their injuries and the bus's safety features, the researchers concluded that injuries to the head, neck and spine will be the most common result of these accidents. “For additional safety, changes to the current bus design are needed,” they wrote. These changes would involve the addition of padding to the sides of the bus, above the windows and to panelling between windows.
Coauthor Mervyn Letts, an orthopedic surgeon, told CMAJ that seat belts remain a contentious issue. Opponents fear incorrect use may lead to additional injuries, and warn that they are expensive to install. However, they do “perform well in crashes, particularly rollovers,” says Alan German, Transport Canada's chief of collision investigations. He also said they reinforce the importance of the devices for the children, who will become drivers in the future.
Letts, who now practises in the United Arab Emirates, says in-bus safety improvements are needed. “If seat belts are not provided, the bus manufacturers should be mandated to provide adequate wall padding to minimize impact trauma, or to develop some kind of side air-bag system.”
Essentially, today's school-bus passengers are cocooned in a seat compartment by high padded seat backs and fronts, with narrow spacing between rows. The seats are strongly anchored and a steel inner structure bends to absorb energy. However, the researchers found that this compartmentalization fails to protect passengers during rollovers. “We believe this is a significant finding,” says Letts. — Barbara Sibbald, CMAJ
Figure. Rollover crashes: rare, but dangerous Photo by: CJS