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Wheelchair Transportation Safety Considerations

Introduction

What is the bottom line? A crash-tested original equipment (OEM) seat with lap shoulder belts in a car, truck, or van is the safest seat in a motor vehicle. However, when someone is unable to transfer onto these seats, there are other options available:

In transportation vehicles, such as buses, cars or trains, your passenger seat is bolted to the vehicle floor. However, when a wheelchair is used as a vehicle seat, this “seat with wheels” needs to be anchored to the floor of the vehicle using crash-tested straps and occupant restraint belts or a docking system to do this. Crash-tested wheelchair transportation safety products are labeled and tested to the same standards as those required for all car, truck, and van occupant safety equipment.

If you are unable to transfer to a seat, you may need to use a different type of vehicle such as a wheelchair accessible van or a different mode of transportation (i.e., car, van, paratransit or bus). For passenger safety during travel, take a look at the following safety recommendations for riding seated in your wheelchair:

  •  4-straps or a dock should be used to secure your wheelchair to the floor of a vehicle.
  • Equipment must be crash-tested according to American National Standards Institute  (ANSI) and Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) standards and properly installed.
  • An occupant restraint system must be fitted to the passenger so the belts have close contact with the sturdy parts of the human body; (i.e., the shoulder, breast-bone and pelvis).
  • These straps must then be anchored either to the vehicle floor or onto the D-rings on the 4-point strap-type wheelchair tiedowns. It is also important to be held safely within your seat using a 3-point lap shoulder belt that is much stronger than a pelvic positioning belt.

These pictures show the proper use of both a 4-point, wheelchair tie down system and a 3-point, crash-tested, lap shoulder belt restraint.

 

A crash-tested docking system is used in private vehicles that accommodate a specific wheelchair. The wheelchair must be customized with add-on hardware and the rider must use a vehicle anchored lap shoulder belt.


This crash-tested Wheelchair Tiedown & occupant restraint
(WTORS) system is used in a public transportation vehicle because it
serves the majority of wheelchair types and passengers.

Airplane Travel

Accommodation of wheelchair users is also mandated by the Americans with Disabilities Act and the Air Carrier Access Act and the Air Carrier Access Amendments Act within the Department of Transportation. Click here for more information: Traveling by Air for Passengers with Disabilities.

Automobile Travel

When you own your own vehicle (typically an accessible van with a ramp or lift or a sedan with hand controls), you can invest in a 2-part docking station that allows much easier, independent wheelchair securement. (see above picture)

One part of the system attaches to the wheelchair and the second part is mounted to an exact place on the floor of the vehicle depending on whether it is for a driver or a passenger. A dock typically allows use of the vehicle’s 3-point vehicle lap shoulder belt for safety restraint. This dock required adding hardware specific to the model of manual or powered wheelchair. This system only works when a modified wheelchair always docks into its own, customized van.

Fixed-Route Public Transit or City Bus

The Americans with Disabilities Act (ADA), passed in 1990, requires that all modes of transportation be accessible for passengers with any type of disability. This includes all passengers who use wheelchairs or other mobility devices like a rollator or rolling walker. All large public transit buses that follow fixed routes must be wheelchair accessible.

Paratransit Travel

Paratransit can be a service of either a public transit system or private organization. If a city or town provides publicly funded transportation, then it is required by the Americans With Disabilities Act to also provide accessible transportation or paratransit. Generally, paratransit services support:

  • “On-demand,” door-to-door travel which must be scheduled in advance.
  • In some towns without public transit, a local non-profit organization (e.g. the Red Cross) will provide this service to support its local citizens with disabilities.
  • The operators of paratransit vehicles are trained in wheelchair transportation safety. The vehicle is typically smaller than a public transit bus and uses a vertical hydraulic lift to bring on passengers.

In most situations, you must apply to be a paratransit customer in advance of your need for travel. Certain physical, sensory, health, or geographical limitations are listed as eligibility criteria. Travel is commonly paid for with fixed price tickets which are purchased in advance.

School Bus Travel

School systems around the US vary greatly in the ways that they manage school bus transportation and more specifically in the ways that they educate their special needs bus drivers about best practices for students who use wheelchairs. When a child who uses a wheelchair enrolls in school, they become eligible for school bus transportation and are not bound by restrictions regarding distance from school. Special needs for transportation can become part of the student’s individualized education plan (IEP). This is especially important when respiratory issues, seizure disorders or communication limitations are present.

Some school districts want students to use wheelchairs that have high backs, headrests, and positioning vests. However, when a student uses an ultralight manual wheelchair, the bus attendant or driver should assist this student to make a safe transfer into a typical bus seat that is equipped with passenger safety belt or lap-shoulder belt. The empty ultralight manual chair can be secured to the floor. School-based occupational or physical therapists are often asked to help in situations involving medical necessity.

 

The ADA Requirements for Public Transit

  • Buses must have ramped entries, low floors (no steps) and be equipped with two wheelchair stations.
  • These wheelchair stations are typically placed under side facing bench seats at the front of the bus that flip up when a passenger using a wheelchair boards the bus.
  • Each station is equipped with retractable straps for 4-point tie down (one for each corner of the wheelchair) and a wall mounted, 3-point lap shoulder belt.
  • A lap shoulder belt is needed to keep the wheelchair-seated passenger safely in their chair thus preventing sudden ejection from the wheelchair and subsequent injury. Pelvic positioning belts are NOT designed for use in transportation.

Fixed Route Public Bus Travel
Though transit drivers have some training in use of this wheelchair transportation safety equipment, it is generally the rider’s responsibility to request help with 4-point wheelchair securement straps and 3-point passenger belt placement. The ADA does NOT require that these safety systems are used—only that they are “available” for use. As a result, there is great variability among transit systems.

Pros of Public Transit
The advantage of fixed route transportation is that the person using the wheelchair does not need to do planning for travel 24 to 48 hours in advance. The passenger using a wheelchair only needs to know the route travel schedule and wait at an identified bus stop as travel times are predictable and scheduled and transfers allow use of an entire bus network.

Additionally, the cost of ride is typically a half-price fare with a disability ID. (Most transit systems require that you register as a passenger with a disability and use a personalized photo ID or identification).

Trains: Light Rail or Subway

This type of urban mass transit also operates under the regulations of the ADA. There is great variance since these transportation modes were not common when the ADA became law in 1991. Level boarding platforms, accessible train stations, and room to maneuver on the rail or subway are typical accommodations. There is strong interest in newly developed, user-managed, automated wheelchair and scooter securement devices but these are not commonly installed at the present time.

A new strategy being used in large buses for a wheelchair traveler may be to sit with the rear or back of their mobility device positioned directly in front of a solid wall or barrier in a designated station. This places the wheelchair-seated passenger facing toward the rear of the car bus opposite the direction of the vehicle’s travel. This safety option is based on the higher likelihood of a frontal impact in which a sudden stop would cause the wheelchair and its occupant to be stopped by the barrier or wall.

Transit Safety for Scooters (pdf)

After-Market Safety Equipment

Installing “after-market” safety equipment into a personally owned vehicle requires that the equipment be installed properly and according to strict safety standards. Check out the resources section below for the National Mobility Equipment Dealers Association (NMEDA) and the Association for Driver Rehabilitation Specialists (ADED). Their expertise ensures selection of necessary adaptations and its correct installation.

Because of the importance of choosing exactly the right equipment and installing for optimal use, NMEDA-certified dealers will require an evaluation and specification from an ADED therapist. Most health insurance does not pay for driver evaluation or wheelchair transportation safety equipment. The exceptions to this are the VA Healthcare system and the state-wide office of vocational rehabilitation when wheelchair-seated travel is needed for access to employment.

Resources for Additional Information on Wheelchair Transportation Safety

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