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Thomas M. Rice, PhD, MPH and Craig L. Anderson, DHSc, PhD

Thomas M. Rice is with the Traffic Safety Center at the School of Public Health, University of California, Berkeley. Craig L. Anderson is with the Department of Emergency Medicine and the Center for Trauma and Injury Prevention Research at the University of California, Irvine.

Correspondence: Requests for reprints should be sent to Thomas Rice, Traffic Safety Center, 2614 Dwight Way #7374, Berkeley, CA 94720–7374 (e-mail: tomrice{at}berkeley.edu).

Objectives. We estimated the effectiveness of child restraints in preventing death during motor vehicle collisions among children 3 years or younger.

Methods. We conducted a matched cohort study using Fatality Analysis Reporting System data from 1996 to 2005. We estimated death risk ratios using conditional Poisson regression, bootstrapping, multiple imputation, and a sensitivity analysis of misclassification bias. We examined possible effect modification by selected factors.

Results. The estimated death risk ratios comparing child safety seats with no restraint were 0.27 (95% confidence interval [CI] = 0.21, 0.34) for infants, 0.24 (95% CI = 0.19, 0.30) for children aged 1 year, 0.40 (95% CI = 0.32, 0.51) for those aged 2 years, and 0.41 (95% CI = 0.33, 0.52) for those aged 3 years. Estimated safety seat effectiveness was greater during rollover collisions, in rural environments, and in light trucks. We estimated seat belts to be as effective as safety seats in preventing death for children aged 2 and 3 years.

Conclusions. Child safety seats are highly effective in reducing the risk of death during severe traffic collisions and generally outperform seat belts. Parents should be encouraged to use child safety seats in favor of seat belts.

This article has been cited by other articles:

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