Safety on the school run

Earlier this month, exactly on May 9, by implementation of an EU directive, it became mandatory for school transport vehicles to be equipped with seat belts. While there is little doubt that properly-maintained and age-appropriate lap and shoulder belts can save lives, it is by no means the solution to all school transportation safety concerns.

In western counties where these statistics are available, about one fourth of school children use a school bus. Sixty per cent are driven to school in family cars and about 15 per cent walk to school. Yet, in these same countries deaths on school buses make up only two per cent of all school transport-related deaths. About three fourths of such deaths result from crashes by passenger vehicles driven by family members or neighbours. Sixteen per cent of fatalities are, in turn, sustained by child pedestrians - the majority of these being children actually struck by the school bus itself!

From these figures it is evident that school buses are by far the safest mode of school transport for children. Any measure, such as pushing up prices, that discourage parents from sending their children to school by bus will, therefore, increase the risk to the children.

Numerous studies have shown that the combination of lap/shoulder seat belts are best for decreasing the rates of injuries when compared to no seat belts or lap belts only. In fact, lap belts used without the shoulder restraint can actually increase the incidence and severity of head injuries. In a frontal collision, a lap belt used alone will hold the child's pelvis in place allowing the upper body and head to strike a seat back with greater force. Similarly, a combined lap/shoulder belt must be height and weight adjustable because placing a small child in an "adult" seat restraint is likely to cause abdominal injuries in a severe crash.

School bus crashes, however, are not the only concern. It has been estimated, for instance, that an idling engine increases the risk of on-board pollution to such an extent that the lifelong cancer risk of passengers rises by four per cent. Clearly, cleaner, more modern technology is necessary to safeguard our children's health.

However, the biggest scope for decreasing the rate of school transport-related injuries is towards child pedestrians.

School buses/minivans must be equipped with adequate mirrors to eliminate blind spots.

Also electronic backing sensors should be installed to warn drivers of children crossing behind a reversing bus. Schools should strongly consider having adult bus monitors riding with the children.

Besides making sure that everyone is belted in properly, these monitors can escort children across the road after coming off the bus. This measure alone is estimated to reduce injuries by half!

Enforcing seat belt use on school buses is a step in the right direction. But unless it is done properly and in tandem with other measures, it will fall short of proving safe school transport to our children.

Mr Fearne is consultant paediatric surgeon at Mater Dei Hospital and lecturer in paediatric surgery, University of Malta.