Unintentional nontraffic injury and fatal events: threats to children in and around vehicles

<b>Objective</b> There have been substantial reductions in motor vehicle crash-related child fatalities due to advances in legislation, public safety campaigns, and engineering. Less is known about nontraffic injuries and fatalities to children in and around motor vehicles. The objective of this study was to describe the frequency of various nontraffic incidents, injuries, and fatalities to children using a unique surveillance system and database. <b>Methods</b> Instances of nontraffic injuries and fatalities in the United States to children 0–14 years were tracked from January 1990 – December 2014 using a compilation of sources including media reports, individual accounts from families of affected children, medical examiner reports, police reports, child death review teams, coroner reports, medical professionals, legal professionals, and other various modes of publication. <b>Results</b> Over the 25-year period, there were at least 11,759 events resulting in 3,396 deaths. The median age of the affected child was 3.7 years. The incident types included 3,115 children unattended in hot vehicles 729 deaths, 2,251 backovers 1,232 deaths, 1,439 frontovers 692 deaths, 777 vehicles knocked into motion 227 deaths, 415 underage drivers 203 deaths, 172 power window incidents 61 deaths, 134 falls 54 deaths and 79 fires 41 deaths, and 3,377 other incidents 157 deaths. <b>Conclusions</b> Nontraffic injuries and fatalities present an important threat to the safety and lives of very young children. Future efforts should consider complimentary surveillance mechanisms to systematically and comprehensively capture of all nontraffic incidents. Continued education, engineering modifications, advocacy, and legislation can help continue to prevent these incidents and must be incorporated in overall child vehicle safety initiatives.