Fatal Pediatric Motor Vehicle Crashes on U.S. Native American Indian Lands Compared to Adjacent Non-Indian Lands: Restraint Use and Injury by Driver, Vehicle, Roadway and Crash Characteristics

Oh, Shin Ah; Liu, Chang; Pressley, Joyce C.

doi:10.3390/ijerph14111287

Cited by 4 publications

(5 citation statements)

References 19 publications

(22 reference statements)

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“…While the majority of children were restrained in a child restraint system, about one-fifth of children were unrestrained or restrained in a non-child restraint system. The finding that unrestrained children involved in a fatal crash were more likely to be transported by drivers who were unrestrained, younger (aged < 20 years) and positive for alcohol is consistent with previous studies (Hertz, 1996; Huang et al, 2016; Oh et al, 2017). These findings of lack of restraint use by drivers suggests an area where enforcement of seat belt laws in adults transporting children might improve the safety of child passengers as well.…”

Section: Discussionsupporting

confidence: 91%

Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway

2019

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Background Use of appropriate child passenger safety restraints reduces injury in infants, with rear facing restraints favored over forward facing. In 2011, the American Academy of Pediatrics (AAP) began recommending that infants and children under the age of 2 years be restrained in a rear-facing seat installed in the vehicle’s rear seat. This study examines the practice of rear-facing restraints pre- and post-AAP recommendations for children under 2 years. Methods Data from the Fatality Analysis Reporting System (FARS) from 2008 to 2015 were used to examine restraint status and injuries in rear-seated infants and toddlers aged 0 to less than 2 years involved in fatal collisions ( n = 4966). Subpopulation analyses were conducted on 1557 children with seat facing direction recorded. Multivariable logistic regression was used to generate odds ratios (OR) with 95% confidence intervals (CI). Covariates considered for inclusion in the multivariable model included passenger characteristics (age, gender, seating position), driver characteristics (age, gender, seat belt status, alcohol status, drug status, previous traffic violations), vehicle characteristics (vehicle type), and crash-level characteristics (day/night, weekday/weekend, rush hour, expressway/surface street, urban/rural). Results Approximately 6.7% (330 of 4996) of infants and toddlers were unrestrained with mortality that was approximately triple that of restrained infants (40.0% vs 13.7%, P < 0.0001). In multivariable adjusted models, predictors of an infant being unrestrained included unrestrained driver (OR: 3.17, 95% CI: 2.38–4.21), driver aged less than 20 years (OR: 2.18, 95% CI: 1.42–3.34), driver alcohol use (OR: 2.21, 95% CI: 1.42–3.44), center-seated infant (OR: 1.55, 95% CI: 1.19–2.03) and weekday crash (OR: 1.52, 95% CI: 1.12–2.01). Of all rear-seated children whose restraint status were reported (4966), rear-facing restraint use increased from 5.0% to 23.2% between 2008 and 2015 ( P < 0.0001). The odds of rear-facing restraint use increased after introduction of the AAP guideline among infants aged 0 to < 1 year old (OR: 2.12, 95% CI: 1.46–3.10) and among toddlers aged 1 to < 2 years old (OR: 1.97, 95% CI: 1.03–3.79). Conclusion Trends in the use of rear-facing child restraints improved over the timeframe of this study, but remain low despite the introduction of AAP guidelines and the strengthening of child restraint laws.

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Section: Discussionsupporting

confidence: 91%

Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway

2019

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“…In an analysis of fatality data from 2000 to 2014, Shin and colleagues found that restraint use in Indian lands was significantly lower than that of non-Indian lands. 29 Building upon early observational reports, 33,34 our findings also suggest that fatally injured black children also face a higher risk of unrestraint and inappropriate restraint than white children. Furthermore, the observed racial difference in age-appropriate CRS use remained statistically significant, even after we adjusted for relevant risk factors.…”

Section: Discussionsupporting

confidence: 61%

“…3,5,19 Furthermore, observational studies have connected several factors with the misuse or nonuse of CRSs, including legislation, socioeconomic indicators, race, age (of the child and parent), ease of the CRS installation, and parental beliefs. 4,20-29 Although previous studies have shed light on the circumstances related to restraint use, few have analyzed population-level MVC fatality data using the AAP’s definition of age-appropriate CRS use, while simultaneously adjusting for multiple risk factors. The objectives of this study were to identify factors associated with age-appropriate CRS use in fatal MVCs, as well as characterize overall patterns in CRS use among fatally injured 4- to 7-year-old child passengers.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Child Restraint Use in Motor Vehicle Crashes

Privette

Nwosu

Pope

et al. 2018

Clin Pediatr (Phila)

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Motor vehicle crashes (MVCs) are a leading cause of death among children. Multivariable analyses of age-appropriate child restraint system (CRS) use in the "booster-aged" population are needed. The current study identified factors associated with age-appropriate CRS use in fatal MVCs for children 4 to 7 years old, using 2011 to 2015 data from the Fatality Analysis Reporting System. Of 929 MVC fatalities, 32% of fatally injured children were in an age-appropriate restraint. While age-appropriate CRS use was higher for 4-, 5-, and 6-year-olds relative to 7-year-olds (adjusted relative risk [aRR] = 2.57, 2.51, and 2.18, respectively; p < .01 for each comparison), black children (aRR = 0.62; p < .01) relative to white children, and drivers who had not used a lap-shoulder belt (aRR = 0.40; p < .01) relative to belted drivers were associated with lower levels of age-appropriate CRS use. Our findings underscore the continued importance of communicating best practice guidelines on CRSs to caregivers of young children.

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“…In 2017, New York's observed front seat belt wearing was at 93% [29]. However, seat belt wearing is lower in fatal crashes, in nighttime crashes, in teens not covered by graduated driver licenses, in rear seated occupants, in taxis and vehicles for hire, in older vehicles, in those using alcohol or drugs and across geographical areas [1,[30][31][32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Fatal Motor Vehicle Crashes in Upstate and Long Island New York: The Impact of High Visibility Seat Belt Enforcement on Multiple Risky Driving Behaviors

Pressley

Puri

2023

IJERPH

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Despite an observed daytime front-seat seat belt use that exceeds 90%, nearly half of motor vehicle occupants who die in New York State (NYS) each year are not wearing a seat belt. Crash outcomes were examined by occupant, vehicle, environmental and traffic enforcement patterns related to the annual Click It or Ticket high visibility seat belt enforcement campaign. Three periods of enforcement were examined: pre-enforcement, peri-enforcement (during/immediately after), and post-enforcement. Of the 14.4 million traffic citations, 713,990 (5.0%) were seat belt violations. Relative risk with 95% CI was assessed using deaths from the Fatality Analysis Reporting System (FARS) and SAS Glimmix 9.4 software. Mortality was lower peri-enforcement (32.9%) compared to pre- (40.9%) or post-enforcement (37.1%) (p < 0.001) and tended to be elevated in low enforcement response areas (43.6%). Fatalities were 30% lower (0.7, 95% CI 0.6–0.9) during peri-enforcement in models adjusted for demographics, law coverage, enforcement response, rural, weekend, impairment, speeding, and vehicle type. Adjusted mortality was higher in rural (1.9, 1.6–2.6), alcohol-involved (1.8, 1.4–2.9), and speeding-involved (2.0, 1.7–2.5) crashes. Peri-enforcement alcohol- and speed-involved fatalities tended to be lower in restrained, unrestrained and occupants missing belt status. The finding of lower mortality in both belted and unbelted occupant’s peri-enforcement—in the context of fewer fatal speed and alcohol-involved crashes—suggests that the mechanism(s) through which high visibility seat belt enforcement lowers mortality is through impacting multiple risky driving behaviors.

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Fatal Pediatric Motor Vehicle Crashes on U.S. Native American Indian Lands Compared to Adjacent Non-Indian Lands: Restraint Use and Injury by Driver, Vehicle, Roadway and Crash Characteristics

Cited by 4 publications

References 19 publications

Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway

Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway

Factors Associated With Child Restraint Use in Motor Vehicle Crashes

Fatal Motor Vehicle Crashes in Upstate and Long Island New York: The Impact of High Visibility Seat Belt Enforcement on Multiple Risky Driving Behaviors

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