Childhood obesity leads to many health problems, but the data are mixed as to whether there is a potential for increased injury rates in motor-vehicle crashes (Haricharan et al. 2009, Zonfrillo et al. 2011, Zaveri et al. 2009). A primary concern is that children may not be able to follow best-practice recommendations for their age (rear-facing until 2 years, harnessed restraint to at least age 4, booster seat until age 8-12 when the seatbelt fits correctly) because they exceed the weight limit of the available products (Trifiletti et al. 2006, Fitzharris et al. 2008, Bahlmann et al. 2009). For example, a three-year-old weighing 36 kg (80 lb) would be too heavy for nearly all forward-facing harnessed restraints, but probably would not sit correctly in a booster that allows increased freedom of movement. For children using child restraints when they meet the weight limit, the dimensions of the product or the harness system may not fit them appropriately. Another challenge is that pediatric crash dummies represent average sizes of children, and cannot identify how an obese child may interact differently with the restraint.

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