Pediatric Restraint Use and Injury in New York City Taxis Compared with Other Passenger Vehicles

Abstract

In New York City (NYC), as in several other U.S. cities, pediatric occupant restraint laws exempt rear-seated passengers in vehicles-for-hire from those that apply to private vehicles. This study compares rear-seated infant, child, adolescent, and teen passenger restraint use and injury in taxis compared with other passenger vehicles. New York State Department of Health Crash Outcome Data Evaluation System (CODES) was analyzed for rear-seated pediatric passengers aged 0–19 years traveling in taxis ( n = 1,631) or other passenger vehicles ( n = 21,984) involved in a crash in NYC 2011–2013. CODES is a probabilistically linked data set comprising emergency department, hospitalization, and Department of Motor Vehicle crash data. Bivariate and multivariable logistic regression odds ratios (OR) are reported with 95% CI. Taxi passenger restraint use was lower than in other passenger vehicles (51.2% vs. 86.7%, p < 0.0001). Use of a child restraint for ages < 8 years was low (5.9%) and one-tenth that of other passenger vehicles. Multivariable adjusted odds of restraint use was 9.80 (8.2–11.7) for other passenger vehicles compared with taxis. Compared with passengers in other vehicles, passengers in taxi crashes were twice as likely to be moderately or severely injured ( p < 0.0001) and twice as likely to have traumatic brain injury ( p = 0.0070). This study documents lower restraint use and higher injury, including traumatic brain injury, for pediatric taxi passengers compared with other passenger vehicles. Improved data systems, surveillance, and enforcement are needed to improve restraint use and reduce injury in children and teens, particularly those in vehicles-for-hire.

What Are the Restraint Practices, Preferences, and Experiences When Australian Parents Travel with Their Children in a Rideshare Vehicle?

“…For example, while 85.6 percent of participants reported that they 'always' restrained their youngest child in an appropriate restraint while travelling in their private motor vehicle, only 57.3 percent of participants reported that they 'always' restrained their youngest child in an appropriate restraint when they travelled in a rideshare vehicle. These findings are consistent with several studies from the United States who have recently noted that parents restrain their children 'differently' while travelling in alternative transport modes such as rideshare vehicles [6,19], taxis [16,18], or carpooling [17]. These findings have significant implications, suggesting that child occupants may be at an increased risk of death or serious injury in the event of a motor vehicle crash while travelling in these modes of transport.…”

“…Although child restraint use is high (i.e., over 90%) in private motor vehicles in Australia [13][14][15], research has shown that child restraint use is substantially lower in shared transportation modes such as taxis, rideshare vehicles and carpooling [6,[16][17][18][19]. For example, in the United States, Owens and colleagues [6] reported that 59 percent of parents restrained their children aged five years and younger 'differently' when travelling in a rideshare vehicle than they did when travelling in their private motor vehicle, including holding the child on their lap (37.0%) or letting their child travel without an appropriate child restraint (25.0%).…”

Using Crash Outcome Data Evaluation System (CODES) to examine injury in front vs. rear-seated infants and children involved in a motor vehicle crash in New York State

“…Failure to link could have underestimated the incidence of injury in this study population, but crashes that linked had high fidelity. Vehicles for hire have been shown to have lower overall restraint use and higher injury rates among children compared to private vehicles (Prince et al, 2019 ). This analysis did not differentiate between privately-owned vehicles and vehicles for hire such as taxi cabs, Uber, Lyft, and other ride-share modes of transit.…”

The Power of Academic-Practitioner Collaboration to Enhance Science and Practice Integration: Injury and Violence Prevention Case Studies

“…The fruits of this ongoing academic-practice partnership—which yielded important, actionable data—helped to raise the profile of this injury issue among injury prevention professionals, policymakers, and residents and visitors. It also stimulated the co-writing of a grant to support further analysis of CODES in aging and frail adult populations, a conference on rear-seat safety, a webinar 29 , a scientific meeting abstract, and forthcoming peer-reviewed manuscripts 30 coauthored by the NYSDOH and CU-ICRC collaborators. Additionally, the NYSDOH/CU-ICRC academic-practice partnership provided a training opportunity for interns, strengthened scientific collaborations through use of diverse perspectives, and increased access to the CODES database to narrow scientific gaps and strengthen evidence-based public messaging around rear seat passenger safety.…”