The Danger of Premature Graduation to Seat Belts for Young Children

Winston, Flaura Koplin; Durbin, Dennis R.; Kallan, Michael J.; Moll, Elisa K.

doi:10.1542/peds.105.6.1179

Cited by 218 publications

(153 citation statements)

References 7 publications

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“…Compared to children placed in booster seats, those restrained with a safety belt are 3.5 times more likely to suffer a significant injury and 4.2 times more likely to suffer a significant head trauma in a crash (Winston, Durbin, Kallan, Moll, 2000). Adult safety belts are designed to fit and protect individuals with typical adult stature.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the use of booster seats: A state-wide survey of parents

Bingham

Eby

Hockanson

et al. 2006

Accident Analysis & Prevention

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This study gathered telephone interview data on attitudes, knowledge and motivations regarding booster seat use from a representative stratified random sample of parents with children between the ages of 4 and 8 years living in the State of Michigan. Interviews were completed between December 1 and December 15, 2004, with parents of children in 350 households. Due to demographic differences between this sample and the National Household Travel Survey (NHTS), weights were calculated using NHTS data, and both unweighted and weighted analyses were conducted. No differences were found between the conclusions drawn from the weighted and unweighted analyses; therefore, unweighted results were reported. Analyses examined the sample, overall, part-time booster seat users, and booster seat non-users. Numerous differences were identified based on parental sex, and booster seat use. Results indicated that the lack of legislation mandating booster seat use was a key variable determining level of use and the motivation to use booster seats. Nearly 70% of part-time users said that they used booster seats because they believed it was the law. Similarly, 60% of part-time and non-booster seat users said that they would be more likely to use booster seats if use were mandated by law, with non-users being more than three times as likely as part-time users to agree that a law would increase their booster seat use. Finally, over 90% of part-time and non-booster seat users said it would be easier for them to use booster seats if a law required it, and non-users were almost three times more likely than part-time users to agree that a law would make use easier. The need for booster seat laws, issues of social equity, and implications for intervention were discussed. Key WordBooster seat use, restraint use, safety belt use, telephone survey, representative, occupant protection SI* (MODERN METRIC) CONVERSION FACTORS APPROXIMATE CONVERSIONS TO SI UNITS Introduction BackgroundIt is widely recognized in the fields of injury prevention and transportation safety that motor vehicle crash (crash) is the leading cause of morbidity and mortality among children ages 4 to 8 years (Subrmanian, 2005). Although motor-vehicle-related injuries have declined in recent years (National Highway Traffic Safety Administration [NHTSA], 2003a), child restraint non-use is common in this age group, and contributes significantly to the risk of crash-related injury. Booster seats are important and effective tools in the effort to protect young children from injury in crashes, decreasing the risk of injury in a crash by as much as 59% (Durbin, Elliot, Winston, 2003;Nance et. al., 2004).In spite of their effectiveness (Durbin, Kallan, Winston, 2001), children who have outgrown child safety seats (i.e., infant or toddler seats) but are still too small to be fully protected by a safety belt designed for an adult (adult safety belt, i.e., lap and shoulder), are often either not placed in booster seats, placed inappropriately in a safety belt, or not restrained...

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Section: Introductionmentioning

confidence: 99%

Factors influencing the use of booster seats: A state-wide survey of parents

Bingham

Eby

Hockanson

et al. 2006

Accident Analysis & Prevention

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“…11 Overall, booster seat use was 27.7%, however, only 10% of children age 6 years and older were restrained in booster seats.…”

Section: Reasons For Nonusementioning

confidence: 95%

“…Children aged 2 to 5 years restrained in vehicle seat belts are 4.2 times more likely to sustain a clinically significant (AIS >_ 2) head injury than children restrained in child safety seats or booster seats. [11] Two groups of children are prematurely graduated from child restraints to vehicle safety belts: (1) children under 40 pounds who should be restrained in child safety seats; and (2) children over 40 pounds who have outgrown their child safety seats and move to seat belts, but should be restrained in booster seats. While child safety seat usage is as high as 61.2% for children under five, a national survey of parents conducted by the National SAFE KIDS Campaign found that less than 5% of families used booster seats for their children.…”

Section: IVmentioning

confidence: 99%

“…[11] In addition, children restrained in seat belts are 4.2 times more likely to have a clinically significant head injury such as concussion, skull fracture, or a more serious internal brain injury. These data support the need to reduce premature graduation and point to head injuries as another significant injury problem related to premature graduation.…”

Section: B Head Injuriesmentioning

confidence: 99%

“…These data support the need to reduce premature graduation and point to head injuries as another significant injury problem related to premature graduation. [11] The mechanism for these head injuries in children could be related to the placement of the shoulder belt. The seat belt does not fit young children properly.…”

Section: B Head Injuriesmentioning

confidence: 99%

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The premature graduation of children from child restraints to vehicle safety belts

Winston¹,

Moll²,

Durbin³

et al. 2000

PsycEXTRA Dataset

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Belt-positioning booster seats are recommended for children between 40 and 80 pounds, however, usage is estimated at only 5% nationally. The goal of this project was to determine reasons for the premature graduation of children from child safety seats to vehicle seat belts and to suggest strategies for increasing booster seat use.The project utilized multiple methods, including a review of existing literature and programs regarding premature graduation and booster seat use; discussions with parents, children, and experts via telephone or focus groups; and facilitated brainstorming sessions. These qualitative methods were used to gain a broad understanding of the issues relating to the premature use of seat belts by young children and to suggest strategies to increase booster seat use.This research showed that the premature graduation of children from child safety seats to vehicle seat belts occurs for a variety of reasons. Most notably, a parent's perception of risk of their child being injured in a crash plays an important role -parents who used booster seats tended to have a higher risk perception than parents who used seat belts for their children. Parents' knowledge of best practice for child passenger safety and the potential consequences for not following these recommendations played a key role among the subjects studied in this research. Parents identified several potential barriers to optimal restraint for their young children including situational circumstances (e.g., extra adult or child in the vehicle), child behavior, child discomfort, the law, availability of the booster seat, cost, convenience/ ease of use, and perceptions of safer alternatives. This research also identified potential strategies to overcome barriers to booster seat use, and to promote continued booster seat use among parents who use them. ii Executive SummarySeat belts do not properly fit young children. The lap belt rides up around the child's waist and the shoulder belt crosses the face or neck, often causing the child to place the belt behind his/her back or under his/her arm. This reduces the effectiveness and compromises the torso restraint. As a result, the premature use of seat belts can cause significant injury in the event of a motor vehicle crash. In particular, young children restrained using seat belts are 3.5 times more likely to sustain a significant injury and 4.2 times more likely to sustain a significant head injury than children using child safety seats or booster seats (Wnston, et al., 2000). In addition, young children using seat belts are also at risk for seat belt syndrome, which can include serious injuries to the abdomen and/or spine.In order to help prevent these injuries, the National Highway Traffic Safety Administration recommends that children between 40 and 80 pounds be restrained using a belt positioning booster seat.' Unfortunately, however, belt positioning booster seat use is only about 5%nationally. The goal of this project was to determine reasons for the premature graduation of children from chi...

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