Differences in injury rates in child motor vehicle passengers in rural and urban areas in New South Wales, July 2000 to June 2004
- Authors: Du, Wei , Finch, Caroline , Hayen, Andrew , Hatfield, Julie
- Date: 2007
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Public Health Vol. 31, no. 5 (2007), p. 483-488
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- Description: Objectives: To investigate whether the pattern of hospitalised injuries in injured child motor vehicle passengers involved in traffic crashes differs in rural and urban residents of New South Wales (NSW). Methods: This study compared injuries of hospitalised child motor vehicle passengers resident in rural areas with those from urban areas. The NSW Inpatient Statistics Collection (ISC), a population-based dataset, was used to select cases for the period of July 2000 to June 2004. The hospitalised injury rate was calculated according to urban/rural status using Poisson regression, injury rate ratios (IRR) comparing rural and urban children were computed overall and for specific injury types. Results: Overall, 1,286 children (aged 0-15 years) residing in NSW were identified from the NSW ISC internally linked datasets as being separated from hospital for injuries resulting from a motor vehicle crash. The overall hospitalised injury incidence rates for child motor vehicle passengers resident in rural and urban NSW areas were 46.75 (95% CI 36.63-59.66) and 20.13 (95% CI 17.94-22.58) per 100,000 children respectively. The rural/urban IRR for comparing the incidence of hospitalisation was significantly elevated (IRR=2.10, 95% CI 1.78-2.48).The IRR was also significantly elevated across most injury types. The largest risk disparity between rural and urban children was in 9-12 year-olds (IRR=2.33, 95% CI 1.73-3.13). Conclusion and Implications: There is an elevated injury incidence rate in rural resident children, compared with their urban counterparts. This differential should be addressed in future road safety initiatives. © 2007 The Authors. Journal Compilation © 2007 Public Health Association of Australia.
- Description: C1
- Description: 2003005762
Age-specific parental knowledge of restraint transitions influences appropriateness of child occupant restraint use
- Authors: Bilston, Lynne , Finch, Caroline , Hatfield, Julie , Brown, Jill
- Date: 2008
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 14, no. 3 (2008), p. 159-163
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- Description: Objective: To determine the factors that influence appropriate restraint usage by child occupants across the age range for which any type of child restraint may be appropriate (0-10 years). Design: Randomized household telephone survey. Setting: Statewide survey, New South Wales, Australia. Subjects: Parents or carers of children aged 0-10 years. Main outcome measures: Parental reporting of appropriateness of child restraint. Methods: Demographic information and data on age, size, restraint practices, parental knowledge of child occupant safety, and attitude to restraint use was collected using a structured interview. Data were analysed using logistic regression after cluster adjustment. Results: Inappropriate restraint use by children was widespread, particularly in children aged 2+ years. Overall, parental knowledge of appropriate ages for restraint transitions was associated with increased likelihood of appropriate restraint use. Lower levels of formal parental education, larger families, parental restraint non-use, and parent/child negotiability of restraint use were predictors of inappropriate restraint use. For particular child age subgroups, the parental knowledge that predicted appropriate restraint use was specific to that age group. Most parents felt that they knew enough to safely restrain their child, despite widespread inappropriate restraint use. Conclusions: Parents are more likely to make appropriate restraint choices for their children if they possess restraint knowledge specific to their children's age and size. Educational campaigns may be most effective when they provide information for specific ages and transition points. Strategies to overcome parents' misplaced confidence that they know enough to restrain their children safely are also indicated.
- Description: C1
Comparison of methods to correct the miscounting of multiple episodes of care when estimating the incidence of hospitalised injury in child motor vehicle passengers
- Authors: Du, Wei , Hayen, Andrew , Finch, Caroline , Hatfield, Julie
- Date: 2008
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 40, no. 4 (2008), p. 1563-1568
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- Description: This study evaluates the performance of different case selection criteria to account for multiple episodes of care when estimating the hospitalisation rate due to road trauma amongst children. The internally linked NSW Inpatient Statistics Collection (ISC) dataset for the period between 1st July, 2000 and 30th June, 2003 was used to identify the "single" episode of care for each hospitalised child motor vehicle passenger residing in NSW. We used two hospitalised injury definitions of a case based on (1) all-diagnoses and (2) principal diagnosis only. We then developed case selection criteria, based on (a) linkage methods only available from linked ISC datasets; (b) selected variables available in both the linked and unlinked ISC datasets, to exclude repeat episodes of care for an injury. Changes in the estimated hospitalisation rate, and sensitivity and specificity, were calculated for each selection criteria compared to the findings from linkage methods as the "gold standard". None of the correction methods for multiple episodes of care was clearly superior in terms of incidence estimation, sensitivity, and specificity concurrently. However, the correction criterion which is optimal may vary depending on different study objectives and different types of hospitalised injuries. © 2008 Elsevier Ltd. All rights reserved.
Population-level estimates of child restraint practices among children aged 0-12 years in NSW, Australia
- Authors: Brown, Julie , Hatfield, Julie , Du, Wei , Finch, Caroline , Bilston, Lynne
- Date: 2010
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 42, no. 6 (2010), p. 2144-2148
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: This cross-sectional study provides population-referenced data on the restraints used and the extent of incorrect restraint use, among child vehicle passengers aged 0-12 years in NSW, Australia. A multistage stratified cluster sampling plan was used to randomly select vehicles from baby/child health clinics, pre-schools/day care centres, and primary schools across NSW to undergo detailed inspection of restraints used by child occupants within those vehicles. Overall, there were very high restraint usage rates (>99% of sampled children) but fewer than one quarter of children were using the correct size-appropriate restraints. Incorrect use (51.4%) was as common as inappropriate use (51.2%). Incorrect use was highest among users of dedicated child restraint systems (OR 16.0, 95% CI 6.9-36.0), and was more likely among those using size-appropriate restraints than those using inappropriate restraints (OR 1.8 95% CI 1.1-3.2); and among convertible restraints than those designed for a single mode of use (OR 1.5 95% CI 1.2-1.7). As incorrect use substantially reduces the protection from injury that is offered by child restraints, it is important that future strategies to reduce casualties among child occupants target both inappropriate and incorrect use. © 2010 Elsevier Ltd. All rights reserved.
Child restraint fitting stations reduce incorrect restraint use among child occupants
- Authors: Brown, Julie , Finch, Caroline , Hatfield, Julie , Bilston, Lynne
- Date: 2011
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 43, no. 3 (May, 2011), p. 1128-1133
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: This study evaluated the effectiveness of the NSW Restraint Fitting Station Network in preventing incorrect use of rearward facing and forward facing child restraints. The way children used restraints was observed randomly as they arrived at observation sites during a cross-sectional ecological study across New South Wales, Australia. Trained researchers examined restraint system installation once the child left the vehicle. A structured interview was also conducted with the driver. Logistic regression was used to examine the association between parental report of ever having the restraint checked at a Restraint Fitting Station and whether or not the restraint was used correctly, while controlling for potential confounders and accounting for the complex sample design. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The results demonstrated that children of respondents who did not use Restraint Fitting Stations were 1.8 times more likely to be incorrectly using their restraints (95% CI 1.1–2.8) than children of Restraint Fitting Station users. Regardless of whether or not a Restraint Fitting Station had been used, there was a trend towards a greater likelihood of incorrect restraint use as the length of restraint ownership increased (OR 1.3 95% CI 1.0–1.7). These results are important for developing strategies aimed at reducing child occupant casualties by reducing the rate of incorrect restraint use, and support programs encouraging the use of Restraint Fitting Stations and similar services as a countermeasure to incorrect use.