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AJPH First Look, published online ahead of print Dec 4, 2008
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American Journal of Public Health, 10.2105/AJPH.2007.131128


Research and Practice

The Effectiveness of Child Restraint Systems for Children Aged 3 Years or Younger During Motor Vehicle Collisions: 1996 to 2005

Thomas M. Rice 1* Craig L. Anderson 2

1 University of California Berkeley
2 University of California Irvine

* To whom correspondence should be addressed. E-mail: tomrice{at}berkeley.edu.


   Abstract

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.

Key Words: Child and Adolescent Health, Epidemiology, Injury/Emergency Care/Violence




This article has been cited by other articles:


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M. R. Elliott, M. J. Kallan, and D. R. Durbin
CHILD RESTRAINT SYSTEMS FOR YOUNG CHILDREN DURING MOTOR VEHICLE COLLISIONS
Am J Public Health, September 1, 2009; 99(9): 1540 - 1541.
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T. M. Rice and C. L. Anderson
RICE AND ANDERSON RESPOND
Am J Public Health, September 1, 2009; 99(9): 1541 - 1541.
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M. D. Decker
THE USE AND EFFICACY OF CHILD RESTRAINT DEVICES
Am J Public Health, July 1, 2009; 99(7): 1160 - 1160.
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T. M. Rice and C. L. Anderson
RICE AND ANDERSON RESPOND
Am J Public Health, July 1, 2009; 99(7): 1160 - 1161.
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