With her first baby on the way later this month, Kristy Shitaoka, a management analyst for the Army at Fort Shafter, finds herself worrying about how to keep her child safe while driving. That led her to sign up for a free car seat inspection through Kapi'olani Medical Center, one of several inspection sites throughout the state.

"We were taking classes at Kapi'olani and were informed that about 80 percent of car seats are installed incorrectly," Shitaoka said, "so we wanted to make sure ours was installed correctly, because we've never done this before."

The Wednesday afternoon inspection (appointments are required) took just half an hour, and covered everything from how to safely fasten the car seat to the vehicle with a secure seatbelt, to how to snugly settle a baby into the seat so the infant doesn't slide around.

"It was definitely helpful," Shitaoka said. "She used a doll to explain how to do the harness up, and that was really good."

Hawai'i has managed to be one of the safest states in the nation for teenagers, according to recently published statistics, but children ages 1 to 14 continue to be at risk in traffic-related accidents. Data over the last six years from the state Health Department shows a rising number of traffic fatalities for Hawai'i's youngest residents, with the number of deaths going from two in 2001 to seven in 2006.

Since 2000, 28 children under 14 have died in crashes — 14 as occupants of automobiles, 10 as pedestrians, three as bicyclists and one on a moped. That accounts for 9 percent of the state's unintentional deaths of young children.

NEW SAFETY LAW

Car seats and booster seats are key to protecting children who are riding in vehicles from injury in traffic accidents.

In recognition of that, a new Hawai'i law is heightening security for this vulnerable age group.

"The safety restraint laws have recently become stricter," said Marika Ripke, project director for Hawai'i Kids Count, based at the University of Hawai'i-Manoa Center on the Family.

In January, a new law mandating booster seats for children between the ages of 4 and 7 went into effect.

Aside from the new booster seat law, though, older pre-teens may be going unbelted in the backseat, even though Hawai'i law mandates backseat belts for all children under 18.

As they get older, the proportion of children who wear seatbelts drops, said Karen Tessier, child passenger safety program coordinator for the Keiki Injury Prevention Coalition, an agency working to improve child safety.

Data from the state Department of Health's Injury Prevention and Control Program shows that between the years 2001-2005, children who rode unrestrained in cars involved in accidents were twice as likely to have injuries as those who rode restrained.

The federal Department of Transportation allots money each year to states to be used for strategies to protect automobile occupants. Hawai'i allots much of that money to agencies like the Keiki Injury Prevention Coalition, to educate young families in how to properly secure car seats for their babies and youngsters.

But the federal dollars haven't been stable. They dropped from $230,000 in 2005 and 2006 to $160,000 this year, said Gordon Hong, highway safety manager for the state highways department.

MORE FUNDING NEEDED

With less funding, fewer families can be screened to make sure they're using car seats properly.

"We need more money," said Lois Arakaki, a health educator at Kalihi-Palama Health Center who often volunteers her time to inspect car seats for families. "It's a very needed service but the funding is very limited."

About 90 percent of families coming in for help have incorrectly installed car seats in their vehicles, according to Arakaki.

"One of the things (we see) is there's movement left to right that's more than one inch, and you don't want that," she said.

With car seat inspection stations on almost every island, families have the opportunity to check their seats for proper installation, and approximately 1,800 O'ahu families do that annually.

At Kapi'olani Medical Center for Women and Children, one of the busiest inspection stations, Nola Faria spends every Wednesday afternoon educating families about the safe way to secure a car seat in their vehicle — and a baby in the car seat.

As clinical coordinator for community and outreach education, Faria also tells families such critical details as when to keep the child facing the rear, how to keep car seats away from dangerous areas where airbags deploy, and how to adjust the seat harnesses to the infant's size.

"Never put a car seat in the front seat in front of an active airbag," Faria said. "And check with the vehicle manufacturer to make sure there's no side airbags." There have been cases in the U.S. involving infants who were struck and killed when airbags deploy.

HELPING FAMILIES

In helping Shitaoka, Faria secured the car seat in the middle of the backseat, making sure the base didn't move and the seat had snapped securely in place.

"The backseat is the safest place for all children under 12," she said.

In Kalihi, Arakaki said, families often can't afford a car seat, or sometimes may have limited English skills to read installation instructions. Each seat is different, she said, and even health educators need to follow instructions about how to install them properly in the family car.

Even with a number of car seat inspection sites on each island for help with installation or inspections, there could be a month or more wait, Arakaki said.

To help families on small budgets, the health center spends about $1,500 of its limited funding on buying car seats for needy families, with the cost to the family based on what they can afford, Arakaki said. Approximately 200 car seats are given out to needy families a year.

Reach Beverly Creamer at bcreamer@honoluluadvertiser.com.