Association between different restraint use and rear-seated child passenger fatalities a matched cohort study
- Authors: Du, Wei , Hayen, Andrew , Bilston, Lynne , Hatfield, Julie , Finch, Caroline , Brown, Julie
- Date: 2008
- Type: Text , Journal article
- Relation: Archives of Pediatrics & Adolescent Medicine Vol. 162, no. 11 (Nov 2008), p. 1085-1089
- Full Text:
- Reviewed:
- Description: Objective: To investigate the association between restraint use and death in rear-seated child passengers and to examine whether the estimated association varies by restraint type and age. Design: Matched cohort study. Setting: All reported crashed passenger vehicles with at least 2 rear-seated child passengers of whom at least 1 died from the US Fatality Analysis Reporting System for 1998 to 2006. Participants: Rear-seated child passengers aged 2 to 6 years. Interventions: Three models of restraint use: (1) no restraint use, any restraint use; (2) no restraint use, recorded improper restraint use (including improper use of seat belts or child restraints, use of shoulder-only seat belts, and use of an unknown type of restraint), any other restraint use; and (3) no restraint use, improper restraint use, seat belts, and child restraints. Main Outcome Measure: Death within 30 days of a crash. Results: Compared with no restraint use, being restrained reduced the risk of death in rear-seated child passengers (relative risk [RR], 0.33; 95% confidence interval [CI], 0.22-0.49). Compared with improper restraint use, any other restraint use reduced the risk of death (RR, 0.46; 95% CI, 0.20-0.63). The RR of death for using child restraints compared with seat belts was 0.91 (95% CI, 0.57-1.14). Child restraints performed slightly better in fatality risk reduction in children aged 2 to 3 years (RR, 0.24; 95% CI, 0.09-0.33) than in children aged 4 to 6 years (RR, 0.32; 95% CI, 0.11-0.44) compared with traveling unrestrained. Conclusions: This study demonstrates the protective effects of restraints for child passengers and highlights the importance of using restraints correctly.
Relative benefits of population-level interventions targeting restraint-use in child car passengers
- Authors: Du, Wei , Finch, Caroline , Hayen, Andrew , Bilston, Lynne , Brown, Julie , Hatfield, Julie
- Date: 2010
- Type: Text , Journal article
- Relation: Pediatrics Vol. 125, no. 2 (2010), p. 304-312
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text:
- Reviewed:
- Description: Objectives: Because public health resources for injury prevention are limited, methods for comparing competing strategies are needed. We aimed to estimate potential injury reductions for 4 population-level interventions that target restraint practices for child car passengers aged 0 to 12 years. Methods: Population-attributable risk fraction (parf) is a populationlevel estimate of excess risk from exposure to a risk factor. Parfs were calculated for each intervention scenario by using published age-specific mortality/injury relative-risk estimates; restraint practices among injured child car passengers from police-collected data; and observational data for correctness of restraint use in new south wales, australia. Parf reductions were estimated for population uptakes of 25%, 50%, and 75%. Results: Assuming a 50% population uptake, (1) promoting ageappropriate restraint use could prevent additional fatalities (5.1%, infants; 3.4%, 1- To 6-year-olds) and nonfatal injuries (3.2%, infants; 16.2%, 1- To 6-year-olds) compared with promoting any restraint use; (2) further encouraging correct age-appropriate restraint use could also prevent additional fatalities (9.1%, infants; 14.3%, 1- To 6-year-olds) and nonfatal injuries (9.2%, infants; 10.7%, 1- To 6-year-olds); and (3) for children aged 7 to 12 years, promoting correct use of restraints could prevent an additional 3.4% fatalities and 3.1% nonfatal injuries compared with promoting any restraint use. Conclusions: Interventions that target child passenger-restraint practices offer population-level benefits in terms of reduction in fatalities and injuries. These tangible benefits call for action internationally, not only to promote restraint use but correct age-appropriate restraint use for child car passengers. Copyright © 2010 by the American Academy of Pediatrics.