Impact of a new booster seat law

Abstract

Study objectives: The National Highway Traffic Safety Administration has currently estimated infant and toddler safety seat use at 91%, up 31% from 1996, in part because of child safety seat legislation. However, with no booster seat law in place for children who were too small or young for adult vehicle safety belts, booster seat use was estimated at 10%. Local data showed that before January 2002, boosters composed 5.6% (59/1,046) of seats inspected. Child safety seat legislation has historically been more effective than public education. California extended the child restraint law to provide protection for children up to age 6 years or 60 lbs in January 2002. Methods: This was a cross-sectional study of child safety seats inspected at community-based child safety seat inspection events and was conducted in a large metropolitan county. Child safety seat inspection events consisted of an intensive inspection of each child restraint for proper installation and adjustment. A standard collection form was used to record errors encountered and recommendations made to parents or caregivers about proper restraint adjustment and appropriate type of restraint. Descriptive analysis was performed on data collected both pre- and postlegislation. Periods were compared on booster seat use, misuse or error by booster type, age, weight, sibling seats inspected, and vehicle type. Geographic analysis examined spatial implications of inspection location, participants' travel distance, and socioeconomic status. Results: Before January 2002, boosters composed 5.6% of seats inspected, and 37% of these demonstrated at least 1 error. There was a significant difference in misuse by booster type: 80% of shield and 28% of belt positioning boosters had at least 1 misuse (relative risk 2.96). Seventy-five percent of children for whom boosters were inspected also had a sibling's seat inspected. The majority of siblings were younger and in rear-facing or forward-facing seats. Sixty percent of children in shield and 11% of children in belt positioning boosters weighed less than 40 lbs. Preliminary post-January 2002 data show that booster seats inspected increased to 11% and no shield booster seats were inspected. Conclusion: Results demonstrate an increase in the use of booster seats; however, there also remains a need for comprehensive parental education. Study objectives: The National Highway Traffic Safety Administration has currently estimated infant and toddler safety seat use at 91%, up 31% from 1996, in part because of child safety seat legislation. However, with no booster seat law in place for children who were too small or young for adult vehicle safety belts, booster seat use was estimated at 10%. Local data showed that before January 2002, boosters composed 5.6% (59/1,046) of seats inspected. Child safety seat legislation has historically been more effective than public education. California extended the child restraint law to provide protection for children up to age 6 years or 60 lbs in January 2002. Methods: This was a cross-sectional study of child safety seats inspected at community-based child safety seat inspection events and was conducted in a large metropolitan county. Child safety seat inspection events consisted of an intensive inspection of each child restraint for proper installation and adjustment. A standard collection form was used to record errors encountered and recommendations made to parents or caregivers about proper restraint adjustment and appropriate type of restraint. Descriptive analysis was performed on data collected both pre- and postlegislation. Periods were compared on booster seat use, misuse or error by booster type, age, weight, sibling seats inspected, and vehicle type. Geographic analysis examined spatial implications of inspection location, participants' travel distance, and socioeconomic status. Results: Before January 2002, boosters composed 5.6% of seats inspected, and 37% of these demonstrated at least 1 error. There was a significant difference in misuse by booster type: 80% of shield and 28% of belt positioning boosters had at least 1 misuse (relative risk 2.96). Seventy-five percent of children for whom boosters were inspected also had a sibling's seat inspected. The majority of siblings were younger and in rear-facing or forward-facing seats. Sixty percent of children in shield and 11% of children in belt positioning boosters weighed less than 40 lbs. Preliminary post-January 2002 data show that booster seats inspected increased to 11% and no shield booster seats were inspected. Conclusion: Results demonstrate an increase in the use of booster seats; however, there also remains a need for comprehensive parental education.