Variations in booster seat use by child characteristics

Sartin, Emma B.; McDonald, Catherine C.; Long, D. Leann; Stavrinos, Despina; Mirman, Jessica Hafetz

doi:10.1016/j.jsr.2020.04.014

Cited by 6 publications

(1 citation statement)

References 11 publications

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“…Infant and child restraint guidelines from the National Highway Traffic Safety Administration (NHTSA) and American Academy of Pediatrics (AAP) recommend rear-facing restraints for infants, forward facing child restraints when rear-facing restraints have been outgrown, and use of belt-positioning booster seats for children that are at least 4 years of age, 40 pounds, no longer fit forwarding facing child safety seats, but are still too young (less than 8 years of age) or too small (less than 57 in.) to fit properly into seat belts alone (NHTSA, n.d.-a ; Durbin & American Academy of Pediatrics, 2011 ; Huang et al, 2019 ; Sartin et al, 2020 ; Durbin et al, 2018 ). NHSTA also recommends that all children under age 13 years ride in the rear seat (NHTSA, n.d.-a ).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Background In New York State (NYS), motor vehicle (MV) injury to child passengers is a leading cause of hospitalization and emergency department (ED) visits in children aged 0–12 years. NYS laws require appropriate child restraints for ages 0–7 years and safety belts for ages 8 and up while traveling in a private passenger vehicle, but do not specify a seating position. Methods Factors associated with injury in front-seated (n = 11,212) compared to rear-seated (n = 93,092) passengers aged 0–12 years were examined by age groups 0–3, 4–7 and 8–12 years using the 2012–2014 NYS Crash Outcome Data Evaluation System (CODES). CODES consists of Department of Motor Vehicle (DMV) crash reports linked to ED visits and hospitalizations. The front seat was row 1 and the rear rows 2–3. Vehicle towed from scene and air bag deployed were proxies for crash severity. Injury was dichotomized based on Maximum Abbreviated Injury Severity (MAIS) scores greater than zero. Multivariable logistic regression (odds ratios (OR) with 95% CI) was used to examine factors predictive of injury for the total population and for each age group. Results Front-seated children had more frequent injury than those rear-seated (8.46% vs. 4.92%, p < 0.0001). Children in child restraints experienced fewer medically-treated injuries compared to seat belted or unrestrained children (3.80, 6.50 and 13.62%, p < 0.0001 respectively). A higher proportion of children traveling with an unrestrained vs. restrained driver experienced injury (14.50% vs 5.26%, p < 0.0001). After controlling for crash severity, multivariable adjusted predictors of injury for children aged 0–12 years included riding in the front seat (1.20, 1.10–1.31), being unrestrained vs. child restraint (2.13, 1.73–2.62), being restrained in a seat belt vs. child restraint (1.20, 1.11–1.31), and traveling in a car vs. other vehicle type (1.21, 1.14–1.28). Similarly, protective factors included traveling with a restrained driver (0.61, 0.50–0.75), a driver aged < 25 years (0.91, 0.82–0.99), being an occupant of a later vehicle model year 2005–2008 (0.68, 0.53–0.89) or 2009–2015 (0.55, 0.42–0.71) compared to older model years (1970–1993). Conclusions Compared to front-seated children, rear-seated children and children in age-appropriate restraints had lower adjusted odds of medically-treated injury.

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