Transportation Safety Laws for Wheelchairs vs. Infant Car Seats: The Dangerous Double Standard
When it comes to transportation safety laws, there’s a dangerous double standard that leaves one of our most vulnerable populations at risk: the elderly. Car seat manufacturers and families are subject to many regulations to keep kids safe. Conversely, no such federal regulations exist for wheelchairs used as vehicle seats.1
While no one would disagree that car seat safety laws are vital for children’s wellbeing, vehicle passengers riding in wheelchairs are 45 times more likely to be injured in a crash than a typical passenger.2 NEMT providers have a responsibility to make sure that their elderly clients are safely and securely seated during travel. Although there are no regulations, there are a set of standards in place for NEMT operators to determine whether a wheelchair can be considered safe for vehicle travel.
Existing Standards for Wheelchair Travel Safety
The Wheelchair Transportation Standards for North America are voluntary standards that are monitored by the University of Michigan Transportation Research Institute (UMTRI). These standards are the guiding principles that encourage mobility device manufacturers to include crash protection in their chairs and devices.
In 2000, the American National Standards Institute (ANSI) approved No. WC19: “Wheelchairs Used as Seats in Motor Vehicles,” making the guidelines the voluntary national standard in the United States. Furthermore, there are similar international wheelchair transportation safety voluntary standards from the International Organization for Standardization (ISO). Unfortunately, these standards are just that – voluntary. NEMT providers who follow these standards place themselves above their competition in the level of safety and security they can offer their passengers.
Are All “Transport Wheelchairs” WC19 Compliant?
Not all wheelchairs that are advertised as “transport wheelchairs” comply with the WC19 standards. On the contrary, many of them are low quality and will not hold up in the event of a motor vehicle accident. Just because a transport wheelchair has vehicle tie-downs doesn’t mean that it is WC19 compliant. Most NEMT providers, caregivers, accreditation agencies, or even government facility surveyors don’t know how to determine which products and services are properly certified or not. Because the regulations are only voluntary, compliance is easy to overlook. Without a doubt, it is critical for all industry stakeholders not to be complacent regarding the safety of patients, residents, and loved ones.
So, how can you tell if a wheelchair is WC19 certified and, therefore, safe to trust and use for your business?
WC19 Wheelchair Requirements
In order to be WC19 compliant, a wheelchair must meet the following criteria:3
- Four easily accessible securement points on the wheelchair frame
- A wheelchair-anchored pelvic belt restraint
- WC19 labeling on the wheelchair frame and belts
- Successful completion of a 30-mph, 2-g frontal impact crash test without any components failing. An occupied crash test with a test dummy is a plus.
- Securement geometry that accepts a securement strap end fitting hook
- A clear path of travel that allows proper placement of vehicle-mounted occupant safety belts next to the skeletal parts of the passenger’s body
- No sharp edges
The Difference Between Child Seat Regulations and Wheelchair Travel Standards
Like the wheelchair transportation standards, all US states and many territories worldwide have legal requirements about the safety and security of child seats in motor vehicles.11 Unlike child seat regulations, however, the adult wheelchair equipment standards are voluntary and do not account for consistent, proper use.
Wheelchair transport equipment standards are a step in the right direction, but there is still a lack of accessible guidance on the proper use, securement, and positioning of wheelchairs in a vehicle. While the National Highway Traffic Safety Administration (NTHSA) has extensive information about the proper choice of car seats and booster seats for dependent children,12 there is little-to-no guidance for those who use wheelchairs to provide non-emergency medical transportation (NEMT).
Injury Risks in Non-Emergency Medical Transportation (NEMT)
Though research is incomplete about the number of people in wheelchairs who are injured in vehicle travel, there are some sobering statistics. Among the injuries found in preliminary reports, 35% were attributed to improperly secured wheelchairs.13 Because the WTS standards are neither readily available nor mandatory, many NEMT providers have yet to provide this elevated level of service.
Due to the pressure to serve an increased number of patients every year — NEMT employees are sometimes tempted to save time by neglecting to correctly secure or position transport wheelchairs. Even if a serious accident doesn’t occur, bad positioning can lead to agitation or discomfort. Eventually, incorrect wheelchair positioning can cause significant pressure injuries or even falls, which can be costly to operators.
The True Cost of Poor Seating Solutions
Since falls are the leading cause of death for seniors older than 65, proper seating solutions should be a top priority. In fact, researchers estimate that injuries resulting from nonfatal falls cost the healthcare industry $49.5 billion in 2015 alone.14 Similarly, pressure injuries can form during uncomfortable seating on long trips. On account of pressure injuries, the healthcare industry faces $11 billion annually in treatment expenses. Each pressure wound can cost anywhere from $500 to $70,000 to treat — a costly and unnecessary expense.15 Under the circumstances, the most important prevention tactic is comfortable, WC19 certified wheelchairs.
The Case for Higher Standards in Wheelchair Transportation
Some NEMT organizations advocate for provider certifications and mandatory standards for wheelchairs used as vehicle seats. These actions would not only save passengers from injury or even death, they would also help NEMT providers to offer better service. These improvements would provide time and money savings for operators and their clients, in addition to lowered risk of adverse incidents.
Summing up this sentiment, United States Department of Transportation (USDOT) shared this feedback from a 2017 survey:
“The survey results and the input received…indicated a desire by some of the stakeholders for the establishment of mandatory rather than voluntary standards for wheeled mobility devices…There are a few wheelchair manufacturers who manufacture their products to meet these standards, but there are many that are distributed in the U.S. that do not meet any of the voluntary standards.”16
Although there are only a few wheelchair manufacturers who meet these voluntary standards, Travrsa by Broda is proud to be counted among them. If you are looking for an excellent, compliant WC19 transportation wheelchair, then the Travrsa-LT Transport Wheelchair is an excellent choice.
Our Call to Action
While healthcare providers and regulators have strict requirements for new parents to have a certified and properly installed vehicle for their child even to leave the hospital, our elderly and disabled clients have no formal regulations to protect them when they leave a healthcare facility in a wheelchair. In conclusion, we invite you to join Travrsa by Broda in advocating for a change in global mandates to protect the safety of seniors and other wheelchair-dependent populations.
If you want to learn more about WC19 certified wheelchairs and how they can benefit your business, contact us today!
1. Songer, Thomas J et al. (2004) The injury risk to wheelchair occupants using motor vehicle transportation. Annual proceedings. Association for the Advancement of Automotive Medicine vol. 48 pp. 115-29.
2. Buning, M. E., Bertocci, G., Schneider, L. W., Manary, M., Karg, P., Brown, D., & Johnson, S. (2012). RESNA’s position on wheelchairs used as seats in motor vehicles. Assistive technology: the official journal of RESNA, 24(2), 132–141.
3. WC19 Your Ticket to Ride Safely. (2010, August 18). The WC19 Information Resource: Crash-tested wheelchairs & seating systems. https://www.rercwts.org/WC19.html
4. University of Michigan Transportation Research Institute. (n.d.). WC10: RF-WPS. WC Transportation Safety. http://wc-transportation-safety.umtri.umich.edu/wts-standards/wc10-rf-wps.
5. International Organization for Standardization. (2012). ISO 10865-1:2012(en) Wheelchair containment and occupant retention systems for accessible transport vehicles designed for use by both sitting and standing passengers — Part 1: Systems for rearward-facing wheelchair-seated passengers. https://www.iso.org/obp/ui/#iso:std:iso:10865:-1:ed-1:v1:en
6. University of Michigan Transportation Research Institute. (n.d.). WC18: WTORS. WC Transportation Safety. http://wc-transportation-safety.umtri.umich.edu/wts-standards/wc18-wtors.
7. International Organization for Standardization. (2012). ISO 10542-1:2012(en) Technical systems and aids for disabled or handicapped persons — Wheelchair tiedown and occupant-restraint systems — Part 1: Requirements and test methods for all systems. https://www.iso.org/obp/ui/#iso:std:iso:10542:-1:ed-2:v1:en
8. University of Michigan Transportation Research Institute. (n.d.). WC19: Wheelchairs. WC Transportation Safety. https://wc-transportation-safety.umtri.umich.edu/wc19/
9. International Organization for Standardization. (2008). ISO 7176-19(en) Wheelchairs — Part 19: Wheeled mobility devices for use as seats in motor vehicles. https://www.iso.org/obp/ui/#iso:std:iso:7176:-19:ed-2:v1:en
10. University of Michigan Transportation Research Institute. (n.d.). WC20: Seating Systems. WC Transportation Safety. http://wc-transportation-safety.umtri.umich.edu./wtsstandards/wc20-seating-systems.
11. International Organization for Standardization. (2009). ISO 16840-4:2009(en) Wheelchairs — Part 19: Wheeled mobility devices for use as seats in motor vehicles. https://www.iso.org/obp/ui/#iso:std:iso:16840:-4:ed-1:v1:en
12. Governor’s Highway Safety Association. (n.d.). Child Passenger Safety. GHSA. https://www.ghsa.org/state-laws/issues/child%20passenger%20safety
13. National Highway Traffic Safety Administration. (n.d.). Car seats and booster seats. NHTSA. https://www.nhtsa.gov/equipment/car-seats-and-booster-seats
14. Association for the Advancement of Automotive Medicine. (n.d.). The Injury Risk to Wheelchair Occupants Using Motor Vehicle Transportation. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217423
15. American Physical Therapy Association. (2018, March 9). Study: Falls among us adults 65 and older cost $50 billion in 2015. APTA. https://www.apta.org/news/2018/03/09/study-falls-among-us-adults-65-and-older-cost-$50-billion-in-2015
16. Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018, February 1). Review of the current management of pressure ulcers. Advances in wound care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5792240
17. U.S. Department of Transportation Federal Highway Administration. (2017). National Household Travel survey. National Household Travel Survey. https://nhts.ornl.gov/
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When it comes to transportation safety laws, there’s a dangerous double standard that leaves one of our most vulnerable populations at risk: the elderly. Car seat manufacturers and families are subject to many regulations to keep kids safe. Conversely, no such federal regulations exist for wheelchairs used as vehicle seats.1 While no one would disagree that car seat safety laws