«Child Occupant Safety in the Sekondi-Takoradi Metropolis, Ghana: An Observational Study *Solomon Ntow Densu Department of Civil Engineering, Takoradi ...»
Civil and Environmental Research www.iiste.org
ISSN 2224-5790 (Paper) ISSN 2225-0514 (Online)
Vol.6, No.3, 2014
Child Occupant Safety in the Sekondi-Takoradi Metropolis,
Ghana: An Observational Study
*Solomon Ntow Densu
Department of Civil Engineering, Takoradi Polytechnic, P.O. Box 256, Takoradi, Ghana
Email of the corresponding author: firstname.lastname@example.org, email@example.com
Seating positions and restraint use influence the severity of injury among child passengers in the event of a crash.
In light of this, legislation mandating age-appropriate child restraint use, in suitable seating positions was enacted, yet very little is known about its compliance level. This study therefore aimed to assess restriant use and seating positions among children riding in vehicles. Covert but unobstructed synchronised observations of restriant use and seating positions were conducted at 11 automated signalized intersections in the STM. Overall, 3849 occupants, comprising 1535 motorists and 2314 child passengers were clearly observed. A little over one third of the children were riding in the front seats, of which one-half were younger than 5 years of age. 1 in 5 of the children observed were riding on adults laps, with 42% in the front seats. Motorists’ belt use 50.6% (95% C.I=48.10-53.10) was significantly higher than children 6.6% (95% C.I=5.83-7.37). Restraint use among front- seated child passengers (14.0%; 95% C.I=12.63-15.37) was markedly higher than rear-seated ones (3.7%; 95% C.I=2.80-4.61). Children were twice as more (OR=2; 95%C.I=1.14-2.25) likely to be restrained when motorists were belted; and thrice as more (OR=3.18; 95%C.I=2.15-4.72) while travelling with a female motorist. Restriant use was prevalent in private cars, during rush-hours and increased with child’s age. Restriant use was incredibly generally low among children, with significant proportion riding in front seating positions. Efforts should be directed at elevating the understanding of parents concerning the importance of restraining younger children in the rear seats, alongside the provision of restraints at subsidized rates or preferably free of charge, while encouraging their use through well-planned and adequately resourced extensive public education and enforcement campaigns.
Key words: Child restraint use, legislation, seating position, Sekondi-Takoradi Metropolis, Ghana
1. Introduction Every year lots of people lose their lives needlessly on the world’s roads through road traffic crashes (RTCs).
Annually, over 1.2 million people die prematurely and up to 50 million sustain non-fatal injuries through RTCs (World Health Organization (WHO), 2013). Low-and-middle income countries are most affected.
Approximately 91% of the world’s traffic fatalities occur in low-and-middle income countries, which account for 72% of the world’s population, but have only a little over one-half of the world’s registered vehicle population.
This indicates that, low-and-middle bear a disproportionately high burden of road traffic fatalities relative to their level of motorization, (WHO, 2014; as cited in WHO, 2013).
Motor vehicle occupants constitute a significant proportion of global road traffic fatalities. Approximately 31% of the world’s traffic fatalities are vehicle occupants. The situation in Africa as regards in-vehicle fatality is dreary. In Africa, approximately 43% of traffic fatalities are vehicle occupants, which exceed the global average (WHO, 2013).
Road traffic injuries (RTIs) are the leading cause of deaths among children and young adult in both developed and developing countries, accounting for 22.3% of child fatalities globally. RTIs particularly, are the leading cause of deaths among 15-19-year-olds, the second leading cause death among 5-9-year and 10-14-year-olds, and the ninth leading cause of death among 1-4-year-olds globally (WHO, 2008). In Ghana, over 1900 persons die through RTCs, of which 46.4% are vehicle occupants. Children between 0-15 years are the most vulnerable road users, accounting for 20.7% of traffic fatalities annually (Building and Road Research Institute, 2011).
The seating positions of children in motor vehicles influence the severity of injury sustained and even death in the event of frontal RTCs. The rear seats have been identified to be the best and safest place for children to ride in a motor vehicle. The risk of rear-seated children dying in a fatal RTC overall is 36% lower compared with children in the front seats (Elisa et al., 1998). Lennona et al. (2008) also realized that, in the event of RTCs, the risk of fatality while in the front-seating position more than doubles for children 12 years and younger, with an increase in fatality risk by four-fold for the unrestrained.
Child seating positions in a motor vehicle has attracted the attention of road safety professionals and other stakeholder institutions in recent times, particularly for motor vehicles equipped with air bags. Air bags, though, 85 Civil and Environmental Research www.iiste.org ISSN 2224-5790 (Paper) ISSN 2225-0514 (Online) Vol.6, No.3, 2014 effectively protect adult occupants they are unsafe for child passengers, because of their cataclysmic effect during a RTC. A research conducted by the Children’s Hospital of Philadelphia (CHOP), revealed that children exposed to air bags during a RTC are twice as likely to suffer a serious injury (CHOP, 2014).
Studies have reported that restrained rear-seated children are offered superior occupant protection compared with restrained front-seated children (Zhu et al., 2007; Elisa et al., 1998). In a study to determine the effects of seating position, combined with restraint use on children’s risk of dying in crashes, rear seated children had 35% reduction in risk of dying in vehicles without any airbags, 31% in vehicles equipped only with driver airbags, and 46% in vehicles with passenger airbags compared with children restrained in the front seat (Elisa et al., 1998). Children secured in the rear seats with age-appropriate restraints are thus offered the best protection while travelling in a vehicle.
An unrestrained child passenger is likely to be killed or seriously injured during a crash. The risk of fatality for unrestrained child passengers increases by four-fold during crashes (Lennona et al., 2008). In a 50-km/h crash, an unrestrained child would be thrown forward with a force 30 to 60 times the child’s body weight (Royal Safety Authority, 2009). They would therefore be prone to be thrown about easily, colliding with the interior of the vehicle and seriously injuring themselves and other vehicle occupants, and possible ejection from the vehicle.
Without restraints, even a crash at only 15-km/h can be lethal (European Transport Safety Council, 2006).
A suitable child restraint primarily works by restraining the child passenger in the event of a RTC. Besides, child restraints are effective in reducing injuries that can occur during non-crash events, such as a sudden stop, a swerving evasive manoeuvre or a door opening during vehicle movement (Agran et al., 1985).
The effectiveness of child restraint as a safety measure has technically been established. Child restraints reduce the likelihood of a fatal crash by approximately 70% among infants and between 54% and 80% among young children (Elvik & Vaa, 2004; Zaza et al., 2001; as cited in WHO, 2013) There are lots of health benefits associated with correctly installed and usage of child restriants. For instance, in 2010, in the United State of America, child restraints use saved the lives of 303 children ages 4 and younger (Centers for Disease Control and Prevention, 2014). Furthermore, in the United Kingdom, it was speculated that, new rules on the use of child restraints rather than adult seat belts for children up to age 12 years and above will save over 2000 child injuries or deaths annually (United Kingdom Department for Transport, 2006; as cited in FIA Foundation for Automobile and Society, 2009). It was also reported that in Quebec in Canada, annually, the 1150 annual traffic fatalities and injuries of children under 9 years would have been reduced by 70% if they were restrianed (Societe de l'assurance automobile, 2014).
In light of the health benefits associated with restraints use, lots of countries have enacted legislations, mandating age-appropriate child restraint use in the rear seating positions. In Ghana, efforts to reduce in-vehicle child injuries and fatalities, led to the enactment of seat law (Act 683, 2004). The legislation mandates children under 5 years to be appropriately restrained and ride only in the rear seats. Children 5-18 years of age, in contrast, are required to travel restrained in any seating position, and motorists have the legal reponsibility to ensure adherence to this traffic safety regulation. Yet a decade after the enactment of this traffic safety regulaion, little is known about its actual compliance in any of the ten regional capitals in Ghana. This aim of this study among others, was to determine restriant use by child passengers who are 15years of age or younger, as well as their seating positions in the Sekondi-Takoradi Metropolis, the regional capital of the Western Region of Ghana.
This study will provide a snapshot of the level of child safety delivery in Ghana.
2. Materials and Methods The aim of this study was to assess child passengers age 0-15 years, restraint use and seating position in the STM, as they are most vulnerable road users in Ghana. Additionally, this cohort has special needs while riding in a motor vehicle. Roadside observation survey was employed in this study, as it captures child restrain use in the real world-settings. It thus has a high validity compared with say, self-reported studies, which is more prone to biases as it relies on the integrity of a respondent.
A detailed road map of the study area was obtained, and observational sites were selected. Automated signalcontrolled intersections were selected as they encourage detailed recording of data. These sites were selected in close proximity to shopping malls, educational institutions, and restaurants, essentially to maximize the number of children observed. These sites facilitate detailed screening and recording of restraint use, demographic, and motor vehicle characteristics while these vehicles are momentarily stationary. They also guarantee the safety of the data collectors.
In all, 11 automated signal-controlled intersections were identified in the STM. These sites are fairly distributed in the study area, to provide a representative picture of restraint use across the STM.
Vehicles included in the survey were primarily taxis, private cars, and pick up, save those with tinted windows in this vehicle category. The tinted glasses obscure reliable data collection. Besides, only vehicles with children in the target-age group were included in the study.
Observational survey was conducted in a Wednesday, in December, 2013, purposely to capture traffic flow that is representative of the week. Since good lighting was essential for reliable data collection, visual observations 86 Civil and Environmental Research www.iiste.org ISSN 2224-5790 (Paper) ISSN 2225-0514 (Online) Vol.6, No.3, 2014 were made during the day light hours, from 7:00 am - 6:00 pm. Synchronized observations were made in the morning and afternoon peak and non-peak traffic times, to capture seatbelt use characteristics across these different traffic times, with each observation session lasting for a period of 60 minutes. The morning and afternoon peak periods were 7:00 am-8:00 am and 3:30 pm-4:30 pm respectively, and the corresponding nonpeak periods were 10:00 am -11:00 am and 2:00 pm-3:00pm respectively.
In order to avoid doctoring the collected data, covert but unobstructed observations were made at the signalcontrolled intersections while vehicles were momentarily stationary at intersections’ approaches. Child and driver restraint use, seating position, estimated age group, and gender were recorded for all eligible vehicles observed.
Well-trained observers, conscientiously screened vehicles, when traffic stopped at the intersection’s approach, by moving along the queue of vehicles to register vehicle occupants restraints, seating positions, as well as vehicle and demographic characteristics of each vehicle in turn. These observers receded to their positions, at the traffic lights, when the queue began to move, as the traffic lights turned green. The process was restarted when the lights were back on red, and continued until the 60 minutes observation time elapsed. Each observation site was served for a period of 4-hours, resulting in a total of 44-hours for the entire exercise.
2.1 Data Analysis
The Statistical Package for the Social Sciences (SPSS), version 16.0, and Microsoft Excel Spreadsheet were employed in all data analysis in this study. A database was created using Microsoft Excel Spreadsheet based on previously developed coding scheme. The database was then imported into SPSS for data cleaning. The data cleaning process aided in unearthing and correcting inconsistencies in the database. Frequency tables were generated and cross-tabulations performed using chi-square test to assess statistical significance. Odds ratios (OR) were also calculated at 95% confidence interval (C.I).
3.1 General Characteristics of observational survey Motor vehicles were clearly observed for child restraint use and seating positions in the STM. The road side observation lasted 44-hours, during which time a total of 1535 vehicles were registered (Table 1). Taxis were predominant, with 62% of the observed vehicles, followed by private cars (33%), and pick-up trucks (5%).
In all, a total of 3849 occupants were observed in the 1535 vehicles registered. More than one-half (60%) of these occupants were children and the rest motorists (40%). Among the children population, those younger than 5 years were in the majority (47.4%), followed by 5-6 year olds (34.5%), and 10-15 year olds (18.2%). Similarly, motorists older than 30 years of age, constitute a greater proportion (61%) of the driver population. Male occupants were appreciably higher (69%) than their female counterparts (31%)