OBJECTIVES: To describe the trip characteristics of vehicle crashes involving children, and to examine the effect of situational factors on front row seating or inappropriate restraint for young children.

METHODS: A cross sectional study was conducted on children <16 years in crashes of insured vehicles in 15 US states, with data collected using insurance claims records and a telephone interview. A descriptive analysis of the characteristics of vehicle crashes involving children was performed. Multivariate Poisson regression was used to identify situational factors associated with inappropriate restraint or front row seating.

RESULTS: These data suggest that children were traveling in vehicles involved in crashes that occurred under usual driving circumstances--that is, closer to home (60%), on a local road (56%), during normal daytime hours (71%), within areas with relatively lower posted speed limits (76%). Compared with children involved in morning crashes, those in daytime crashes (RR = 1.65, 95% CI 1.13 to 2.49) or in night-time crashes (RR = 1.63, 95% CI 1.09 to 2.67) were more likely to be sitting in the front seat. Children involved in night-time crashes were more likely to be inappropriately restrained (RR = 1.12, 95% CI 1.01 to 1.22) than those in daytime crashes. Children riding with two or more additional passengers were more likely to be inappropriately restrained (RR = 1.12, 95% CI 1.02 to 1.27) than those with no other passengers.

CONCLUSIONS: Educational initiatives should aim to increase the perception that parents have about the potential crash risk of everyday trips. Some situational characteristics of trips were associated with inappropriate restraint and front row seating behaviors for young children.

The impact of a nationwide effort to reduce airbag-related deaths among children: An examination of fatality trends among younger and older age groups. Nichols JL, Glassbrenner D, Compton RP. J Saf Res 2005.

INTRODUCTION: The purpose of this study was to examine the impact of a nationwide response to emerging airbag-related deaths among children. This response, implemented in 1996, focused on moving children to a rear seat and increasing proper restraint usage.

METHOD: Fatality trends from 1992 through 1996 and from 1996 through 2003 were examined for younger children (ages 0-3) and for older children (ages 4-12).

RESULTS: Prior to 1997, a steady reduction in unrestrained deaths (among younger children) was offset by increases in restrained deaths (among younger and older children), increases in rear-seat deaths (among younger children), and increases in front-seat deaths (among older children). After 1996, there were significant decreases in fatalities in both age groups, with larger and more immediate reductions among the younger children. The largest reductions were immediately after 1996, when younger-child deaths declined by 16%, and after 1999, when deaths among both age groups declined by about 16%.

CONCLUSIONS: The immediate reduction in front-seat deaths among younger children, particularly infants, appears to have been closely associated with the nationwide public information efforts implemented in 1996. Later reductions in front-seat and unrestrained deaths, among both younger and older children, were likely associated with the combination of legislative, enforcement, and public information programs, which increased after 1999.

IMPACT ON INDUSTRY: The findings suggest that a large expenditure of resources by public and private-sector organizations after 1996 resulted in the prevention of hundreds of deaths among young children. In addition, the results provide insights with regard to the categories of deaths most affected by such programs and issues that deserve additional attention.

• Download "Car Seat Safety, Buckling Up Isn't Always Enough" by Michael K. Sachs, MD and Stephanie Tombrello, LCSW Winter 2000. (PDF)
  
• Download Crash Protection for Child Passengers, A Review of Best Practice, by Kathleen Weber. UMTRI Research Review, September 2000. (PDF)

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