Context An increasing number of compact pickup trucks can accommodate restrained
rear occupants. Rear seats in these pickup trucks are exempt from regulatory
safety testing though their relative safety has not been determined.
Objectives To evaluate the risk of injury to children in compact extended-cab pickup
trucks compared with children in other vehicles and to determine if any unique
Design Cross-sectional study of children aged 15 years or younger in crashes
of insured vehicles, with data collected via insurance claim records and a
Setting and Participants Probability sample of 7192 multirow vehicles involved in crashes, with
11 335 child occupants, in 3 large US regions from December 1, 1998,
to November 30, 2000.
Main Outcome Measure Relative risk of injury, defined as concussions and more serious brain
injuries, spinal cord injuries, internal organ injuries, extremity fractures,
and facial lacerations, estimated by odds ratios (ORs) adjusting for age,
restraint use, point of impact, vehicle weight, and crash severity.
Results Injuries were reported for 1356 children, representing 1.6% of the population.
Children in compact extended-cab pickup trucks were at greater risk of injury
than children in other vehicles (adjusted OR, 2.96; 95% confidence interval
[CI], 1.68-5.21). Children in the rear seats of compact pickup trucks were
at substantially greater risk of injury than rear-seated children in other
vehicles (adjusted OR, 4.75; 95% CI, 2.39-9.43). Children seated in the front
seat of compact extended-cab pickup trucks were at greater risk of injury
than children in the front seats of other vehicles, but this risk was not
statistically significant (adjusted OR, 1.70; 95% CI, 0.78-3.69).
Conclusions Children in compact extended-cab pickup trucks are not as safe as children
in other vehicles, primarily due to the increased relative risk of injury
in the back seat. For families with another choice of vehicle, clinicians
should advise parents against transporting children in compact pickup trucks.
The current exemption for regulatory testing for occupant protection in the
rear seats of compact pickup trucks should be reconsidered.