A new national study reveals that school bus-related accidents send 17,000 U.S. children to emergency rooms each year, more than double the number in previous estimates that only included crashes.

Injuries range from cuts and sprains to broken bones, but most require no hospitalization. And researchers point out that, while the numbers are higher than previously reported, they represent a small fraction of the 23.5 million children who travel on school buses nationwide each year. The study appears in November’s Pediatrics, released on Monday.
Nearly one-fourth of the accidents occur when children are boarding or leaving school buses, while crashes account for 42 percent, the new research shows. Slips and falls on buses, getting jostled when buses stop or turn suddenly, and injuries from roughhousing are among other ways kids get hurt on school buses, the data found.
The study’s results provide a strong argument for requiring safety belts on school buses, something industry groups say is unnecessary and is more than many school districts can afford. Safety belts, particularly lap-shoulder belts “could not only prevent injuries related to crashes,” they could also keep kids seated “so they’re not falling out of their seats when buses make normal turns or brake,” said lead author Jennifer McGeehan, researcher at Columbus Children’s Hospital’s Center for Injury Research and Policy in Columbus, Ohio.
The research, involving nonfatal injuries treated in emergency rooms, is based on 2001-2003 data from a surveillance system operated by the U.S. Consumer Product Safety Commission. Some 51,100 children up to age 19 were injured during the study period, or about 17,000 annually, the researchers said.
Data from the government’s National Highway Traffic Safety Administration through 2005 show that about 8,000 children are injured each year in school bus crashes, but on average, fewer than nine are killed. The tally is based on police reports, and not all injuries resulted in emergency room treatment.
In a 2002 report to Congress, NHTSA recommended against lap-only belts in school buses because they can be risky, especially in small children, by restraining them high on the abdomen, potentially causing internal injury in a crash.
Five states California, Florida, Louisiana, New Jersey and New York and some districts have implemented varying safety belt requirements for school buses, according to the National Coalition for School Bus Safety, a nonprofit advocacy group.
The American Academy of Pediatrics advocates having lap-shoulder belts on all new school buses and supports having adult monitors on buses, too, said Dr. Barbara Frankowski, a Vermont pediatrician and chair of academy’s council on school health.

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