Effect of Seating Position and Restraint Use on Injuries to Children in Motor Vehicle Crashes

Berg, Marc D.; Cook, Lawrence J.; Corneli, Howard M.; Vernon, Donald D.; Dean, J. Michael

doi:10.1542/peds.105.4.831

Cited by 94 publications

(60 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[5][6][7][8]10 Those studies all found unrestrained children (particularly those in the front seat) to be at the greatest risk of injury. The results from our multivariate analyses extend those of prior studies by providing additional details on the effects of age-appropriate restraint (not available in other national sources of crash data) and by examining the relative benefits of appropriate restraint and seating position for relevant age groups.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11][12] Although most studies reported that restraint use in rear seats offers the greatest protection to children of any age, Braver et al 8 showed that older children with optimal restraint in the front seat were at lower risk of injury than were unrestrained children in the rear. In addition, the previous studies either did not contain sufficient detail for determination of the ageappropriateness of restraint use [5][6][7][8]10 or did not examine the benefits of appropriate restraint and seating position across a wide range of child ages 9,12 or crash types. 11 Information on the relative benefits of rear seating and appropriate restraint would assist policymakers faced with choices regarding provisions for rear seating or age-appropriate restraint when considering enhancements to state child restraint laws.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effects of Seating Position and Appropriate Restraint Use on the Risk of Injury to Children in Motor Vehicle Crashes

et al. 2005

View full text Add to dashboard Cite

ABSTRACT. Background. Currently, many states are upgrading their child restraint laws to include provisions for the use of age-appropriate restraints through 6 to 8 years of age, with some also requiring rear seating for children, enabling the laws to be in closer alignment with best-practice recommendations.Objective. To evaluate the relationships of seating position and restraint status to the risk of injury among children in passenger vehicle crashes.Methods. This was a cross-sectional study of children <16 years of age who were involved in crashes of insured vehicles in 15 states, with data collected via insurance claims records and a telephone survey. A probability sample of 17 980 children in 11 506 crashes, representing 229 106 children in 146 613 crashes, was collected between December 1, 1998, and November 30, 2002. Parent reports were used to define restraint status, seating position, and occurrence of clinically significant injuries, with the use of a previously validated instrument.Results. Approximately 62% of the children used seat belts, 35% used child restraints, and 3% used no restraint. Nearly 4 of 5 children sat in the rear seat, with one half of all children being restrained appropriately for their age in the rear, although this varied according to the age of the child. Overall, 1.6% of children suffered serious injuries, 13.5% had minor injuries, and 84.9% did not have any injury. Unrestrained children in the front were at the highest risk of injury and appropriately restrained children in the rear were at the lowest risk, for all age groups. Inappropriately restrained children were at nearly twice the risk of injury, compared with appropriately restrained children (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.4 -2.3), whereas unrestrained children were at >3 times the risk (OR: 3.2; 95% CI: 2.5-4.1). The effect of seating row was smaller than the effect of restraint status; children in the front seat were at 40% greater risk of injury, compared with children in the rear seat (OR: 1.4; 95% CI: 1.2-1.7). Had all children in the study population been appropriately restrained in the rear seat, 1014 serious injuries (95% CI: 675-1353 injuries) would have been prevented (with the assumption that restraint effectiveness does not depend on a variety of other driver-related, child-related, crash-related, vehiclerelated, and environmental factors).Conclusions. Age-appropriate restraint confers relatively more safety benefit than rear seating, but the 2 work synergistically to provide the best protection for children in crashes. These results support the current focus on age-appropriate restraint in recently upgraded state child restraint laws. However, it is important to note that considerable added benefit would be realized with additional requirements for rear seating. E xisting guidelines for the optimal protection of children in automobiles recommend rear seating for all children Ͻ13 years of age and the use of age-appropriate restraints, including child safety seats and belt-positioning...

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Effects of Seating Position and Appropriate Restraint Use on the Risk of Injury to Children in Motor Vehicle Crashes

et al. 2005

View full text Add to dashboard Cite

show abstract

“…10, 75,76 The authors of 1 of these studies specifically noted that the beneficial effects of the rear seat were no longer seen for children 13 years and older. 10 Thus, the AAP continues to recommend that all children younger than 13 years ride in the rear seat.…”

Section: Best-practice Recommendation: All Children Younger Than 13 Ymentioning

confidence: 99%

Child Passenger Safety

Durbin¹,

Gardner²,

Baum³

et al. 2011

Pediatrics

View full text Add to dashboard Cite

Despite significant reductions in the number of children killed in motor vehicle crashes over the past decade, crashes continue to be the leading cause of death for children 4 years and older. Therefore, the American Academy of Pediatrics continues to recommend inclusion of child passenger safety anticipatory guidance at every health-supervision visit. This technical report provides a summary of the evidence in support of 5 recommendations for best practices to optimize safety in passenger vehicles for children from birth through adolescence that all pediatricians should know and promote in their routine practice. These recommendations are presented in the revised policy statement on child passenger safety in the form of an algorithm that is intended to facilitate their implementation by pediatricians with their patients and families. The algorithm is designed to cover the majority of situations that pediatricians will encounter in practice. In addition, a summary of evidence on a number of additional issues that affect the safety of children in motor vehicles, including the proper use and installation of child restraints, exposure to air bags, travel in pickup trucks, children left in or around vehicles, and the importance of restraint laws, is provided. Finally, this technical report provides pediatricians with a number of resources for additional information to use when providing anticipatory guidance to families.

show abstract

“…4 Despite the large number of resources allocated to media campaigns, infants and young children continue to travel unrestrained, in unsafe seating positions, and in front passenger seats of airbagequipped vehicles. [5][6][7] We anticipate that this may become more of a problem as vehicles are resold to second owners. As the fleet of airbag-equipped motor vehicles age, increasing numbers of low-income families who may have lower levels of education, inability to read and speak English, larger families, and fewer resources will be using these vehicles.…”

mentioning

confidence: 99%

Child Safety Seat Knowledge Among Parents Utilizing Emergency Services in a Level I Trauma Center in Southern California

et al. 2002

View full text Add to dashboard Cite

ABSTRACT. Objective. To determine the level of child safety seat (CSS) and airbag safety knowledge in parents who utilize emergency care services for their children and to determine factors that influence knowledge of safe transportation of children.Methods. A prospective survey study was conducted in a 42 000-visit-per-year Level I trauma center and emergency department (ED) in Southern California from May through October 2000. Subjects were parents of ED-registered children (<6 years). Research assistants administered the survey in the subject's native language. Parent knowledge of age-appropriate restraint use and airbag safety was collected.Results. Six hundred fifty-five subjects were enrolled. Most parents (97%) reported a regular source of pediatric medical care, and 57% had a previous ED visit. Eighty-six percent reported owning a CSS or booster seat. Eighty-one percent were aware that infants in rear-facing CSSs should never be placed in front of an airbag. Only 46% knew that a child weighing 40 to 60 lb should travel in a booster seat, and 59% knew that the State law required CSS use for children up to 4 years and weighing up to 40 lb. When knowledge scores were examined by ethnicity, fluency in English, income, and years of education, fluency was found to have the greatest influence on both CSS and airbag knowledge.Conclusions. Although nearly all of our subjects admitted that their children had a regular source of care, many parents showed evidence of lack of knowledge of CSS and airbag safety. Furthermore, many parents were not familiar with the state law regarding child restraints. Our findings suggest that parents of small children who utilize emergency care services could benefit from child passenger safety education during their ED visit and that non-English media and materials may be important to reaching this population. Pediatrics 2002;110(5). URL: http://www.pediatrics.org/cgi/content/full/110/5/e61; child safety seat, airbag, knowledge, occupant safety, Hispanic.ABBREVIATIONS. ED, emergency department; CSS, child safety seat; NHTSA, National Highway Traffic Administration. M otor vehicle crashes continue to claim the lives of US children too frequently. In 2000, there were 8145 passenger vehicle occupants under the age of 15 involved in fatal motor vehicle crashes. Of these, 2343 children were killed in crashes. In addition, 529 of the fatally injured children were under the age of 5 years, and 251 were found to be completely unrestrained. 1 Emergency physicians and pediatric emergency medicine specialists are confronted daily with caring for these injured children and in many cases trying to educate parents about "best" child occupant safety practices. The task of injury prevention education in the emergency department (ED) setting can be challenging. Yet most acute health care providers and traffic safety advocates affirm that this education is needed for parents, particularly in light of the growing socioeconomic and cultural diversity found in EDs today. Furthermore, researchers have fo...

show abstract

Effect of Seating Position and Restraint Use on Injuries to Children in Motor Vehicle Crashes

Abstract: Rear seat position during a motor vehicle crash provides a significant protective effect, restraint use furthers this effect, and usage rates of restraint devices are low. The rear seat protective effect is in addition to and independent of the protection offered from restraints.

Cited by 94 publications

References 9 publications

Effects of Seating Position and Appropriate Restraint Use on the Risk of Injury to Children in Motor Vehicle Crashes

Effects of Seating Position and Appropriate Restraint Use on the Risk of Injury to Children in Motor Vehicle Crashes

Child Passenger Safety

Child Safety Seat Knowledge Among Parents Utilizing Emergency Services in a Level I Trauma Center in Southern California

Contact Info

Product

Resources

About