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 well-being, vehicle passengers riding in wheelchairs are 45 times more likely to be injured in a crash than a typical passenger.²

Whether you are a facility providing transportation for residents or a non-emergency medical transportation (NEMT) business, you are responsible for ensuring that wheelchair users are safely and securely seated during travel. Although there are no regulations, there is a set of standards in place to determine whether a wheelchair can be considered safe for vehicle travel. People who are purchasing their own wheelchairs should also be aware of these standards if they intend to use a vehicle for transport and must remain in their wheelchair.

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 use?

WC19 Wheelchair Requirements

In order to be WC19 compliant, a wheelchair must meet the following criteria:³

1. Four easily accessible securement points on the wheelchair frame
2. A wheelchair-anchored pelvic belt restraint
3. WC19 labeling on the wheelchair frame and belts
4. 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.
5. Securement geometry that accepts a securement strap end-fitting hook
6. 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
7. No sharp edges

The Difference Between Child Seat Regulations and Wheelchair Travel Standards

Similarly to 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.10 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 many government agencies, such as the National Highway Traffic Safety Administration (NHTSA), have extensive information about the proper choice of car seats and booster seats for dependent children,11 there is little to no guidance for those who depend on wheelchairs for everyday transportation.

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, however, 35% were attributed to improperly secured wheelchairs.12 Because the WTS standards are neither readily available nor mandatory, caregivers and transporters have little education, inconsistent rules to follow, and few incentives to avoid cutting corners for the sake of convenience.

Poor standardization and communication — combined with pressure to serve an increased number of patients every year — put passengers in a dangerous scenario. There are no external incentives for caregivers and transportation providers to take the time 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.

The Case for Higher Standards in Wheelchair Transportation

Mandatory regulations for wheelchair-accessible vehicles, their drivers, and the mobility wheelchairs themselves would save facilities money and provide incentives for excellent NEMT service. Higher standards would spark greater transparency, therefore giving caregivers more leeway to ensure their residents are properly cared for.

Summing up this sentiment, the United States Department of Transportation (USDOT) shared this feedback from a 2017 survey:

WC19 Certified Wheelchairs by Broda

Although there are few wheelchair manufacturers who meet these voluntary standards, Broda is proud to be counted among them. If you are looking for an excellent, compliant WC19 transportation wheelchair, then Broda is an excellent choice.

Our Call to Action

While new parents must comply with strict car seat requirements for their child to leave the hospital, our elderly or disabled family members and patients have no formal regulations to protect them when they leave a healthcare facility in a wheelchair. In conclusion, we invite you to join Broda in advocating for a change in global mandates to protect the safety of wheelchair users worldwide.

References

1. 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.
2. 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.
3. University of Michigan Transportation Research Institute. (n.d.).WC19: Wheelchairs – WC transportation safety. Retrieved September 10, 2021, from  https://wc-transportation-safety.umtri.umich.edu/wc19/
4. 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. 
5. University of Michigan Transportation Research Institute. (n.d.). WC18: WTORS. WC Transportation Safety.
6. 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. 
7. University of Michigan Transportation Research Institute. (n.d.). WC19: Wheelchairs. WC Transportation Safety. 
8. University of Michigan Transportation Research Institute. (n.d.). WC20: Seating Systems. WC Transportation Safety. 
9. International Organization for Standardization. (2009). ISO 16840-4:2009(en) Wheelchairs — Part 19: Wheeled mobility devices for use as seats in motor vehicles 
10. Governor’s Highway Safety Association. (n.d.). Child Passenger Safety. GHSA.
11. National Highway Traffic Safety Administration. (n.d.). Car seats and booster seats. NHTSA. 
12. Association for the Advancement of Automotive Medicine. (n.d.). The Injury Risk to Wheelchair Occupants Using Motor Vehicle Transportation. NCBI. 
13. American Physical Therapy Association. (2018, March 9). Study: Falls among us adults 65 and older cost $50 billion in 2015. APTA. 
14. Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018, February 1). Review of the current management of pressure ulcers. Advances in Wound Care. 
15. U.S. Department of Transportation Federal Highway Administration. (2017). National Household Travel survey.

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