Tragically, motor-vehicle crashes are the leading cause of death in children. All too often the common factor can be traced to missing or incorrectly installed child safety seats.

In Florida, an estimated 40% of children under the age of six are not restrained when traveling in a vehicle, and of those riding in car seats, 80% are not secured correctly. That means almost 90% of all children under the age of six are riding at risk.

Naturally, parents don't set out to install car seats improperly, but with the many different seat designs and the wide variety of seatbelt arrangements, the vast majority aren't used as intended. Research by the National Highway Traffic Safety Administration shows that proper use of child safety seats can reduce fatal injuries to children under 12 months by 71% and reduce those to children from 1 to 3 years by 54%. This makes child safety seat inspections and classes an important community service — and an area where a fire department can make a significant difference.

Inspection basics

Many parents don't fully understand the child safety restraint guidelines, so educating parents often is a significant aspect of any child safety seat inspection process. As a result, departments that choose to conduct inspections should plan on each taking about 30 minutes.

For example, NHTSA recommends the following restraints:

• Children under 12 months should be in a rear-facing safety seat.
• Children older than 12 months who are between 20 and 40 pounds should be in a front-facing safety seat.
• Children who have exceeded the height or weight limit for their forward-facing seat; are less than 8 years old; and are less than 4 feet, 9 inches tall should be in a booster seat.

The American Academy of Pediatrics recommends that parents never place an infant in the front seat. Children under 15 years old, even if restrained, should also always ride in the back seat of any motor vehicle with a passenger airbag because airbags present a problem to these children in vehicle crashes.

The most frequent problem encountered during inspection is a seat being secured too loosely, allowing it to move an inch or more in each direction. In addition, the child often isn't secured tightly enough. The make and model of a vehicle also influences the kind of safety seat used. For example, a large safety seat may not work well in a small car.

Another risk often identified during inspections is that booster seats are secured improperly or aren't being used when they should be. According to the NHTSA, booster seats are intended for use as a transition to lap and shoulder belts by older children in the 40- to 80-pound range who have outgrown regular car seats. Booster seats are available in two configurations: with high backs, for use in vehicles without head restraints or with low seatbacks, and as backless booster bases.

During the inspection, technicians make sure the child seats are installed correctly. If the vehicle has leather seats, they often add non-slip mats, such as the rubberized mesh sold as kitchen shelf liner, under and behind the child seat to prevent it from shifting. Foam pieces, such as sections of swimming pool “noodles,” can be used to position seats that tilt too far forward to adequately support the head a newborn or very young child. Technicians also check seat makes and models against the recall list found at www.nhtsa.dot.gov.

While the inspection is being conducted, many inspectors find it prudent to have parents complete a form so they can be contacted if the car seats they're using are involved in a recall at a later date. Some inspectors have parents complete a bright, self-adhesive sticker that includes parental contact information, emergency contact information if the parents are injured, and the child's medication needs and doctor's name. These stickers are placed on the back of the safety seat in a location not visible through the car's windows, yet easily accessible by emergency personnel in case of a crash.

The Palm Harbor experience

Palm Harbor (Fla.) Fire Rescue offers free child safety seat inspection at one of the city's four fire stations to citizens who make an appointment. Inspections also are conducted at special events throughout the year at other locations, again at no charge. During an average month, Palm Harbor conducts about 50 inspections by appointment. When a special event is on the calendar, the month's total can increase by half.

While Palm Harbor initially tried conducting its program using six specially trained firefighters spread over the various shifts, the uncertainty posed by emergency runs and other conflicts resulted in too many missed appointments. The program was restructured with a team of two safety technicians to better serve the community. Inspections currently are conducted by the child passenger seat coordinator/program trainer and a firefighter technician.

Another difficulty encountered during the initial program was unpredictable turnout when the department announced no-appointment-necessary community inspection events. Now such opportunities are organized through daycare centers and YMCAs, and those who want an inspection sign up in advance. The turnout actually has increased, and the inspectors always know about how many people will be coming.

Because larger inspection events could strain Palm Harbor Fire Rescue resources, the department partners with others in the county to provide support in the form of technicians and volunteers. Palm Harbor reciprocates when those departments stage inspections. The departments also share the tents, traffic dividers and signage needed at the events.

Certification and recertification of technicians to perform child safety seat inspections is conducted nationally by Safe Kids. Training courses take 32 hours, and technicians must pass a 100-question test. Certification and recertification are important because there's an ever-changing variety of makes and types of seats, as well as vehicles. For a technician to become an instructor, he or she must have six months of active experience as a technician. Becoming an instructor also involves familiarity with the content of an additional training manual and another test.

Palm Harbor's major expenses have been the salary for the part-time child passenger safety coordinator and vehicle fuel costs. The coordinator is active in CPR training and other programs, so the salary is not borne solely by the child safety seat program. Other inspection-related expenses are minor, such as the cost of mesh shelf-liner mats and the cost to recertify staff every two years, which is $40 for a technician and $60 for an instructor.

Program suggestions

If your department plans to seek grant funding for a child safety seat program, it's important to state the problem you intend to address and how you intend to help reduce or eliminate it. Be as specific as possible, using measurable numbers. For example, state how many staff will be certified and how many inspection events will be conducted within a certain period.

To increase public awareness, educational materials will be needed. Preprinted child safety seat literature is available from insurance companies; government agencies such as NHTSA, Safe Kids, the state Department of Transportation; and others. Often private companies will donate printing for local use.

Support your technicians by giving them the training to make them as competent as possible. Help them stay abreast to the latest changes in the field of child safety. Subscribe to publications that provide the latest recall notices and other information.

Form a child safety committee with other departments that meets regularly so that there isn't a duplication of effort and everyone remains informed. Finally, pool your resources with other departments and agencies so that the costs can be shared and events can make as big a difference as possible.

According to Palm Harbor Fire Rescue Chief James Angle and Child Passenger Safety Coordinator Kris Scholz, public feedback about their child safety seat program has been overwhelmingly positive. While the department also conducts swimming pool inspections and other community safety programs, it's the child safety seat program that is remembered and asked for the most. And the numbers show that it's working.

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Jim Weiss and Mickey Davis are Palm Harbor, Fla., freelance writers specializing in emergency services topics.