Patterns of misuse of child safety seats

Abstract

This project addressed the patterns of child safety seat (CSS) misuse in the nation and reported on the most appropriate techniques to accurately and efficiently collect these data. CSS use and misuse observations were collected for about 5,900 target young children (under 60 pounds) in over 4,000 vehicles in the following four states: Mississippi, Missouri, Pennsylvania, and Washington. Results showed overall restraint use for target children was 87.2%. CSS and safety belt use was 50.6% and 36.6%, respectively. The remainder of target children were unrestrained (12.8%). Correct CSS use was defined as proper use of all of the following CSS elements: seat direction, vehicle safety belt routing, harness buckle and harness strap, harness retainer (chest) clip, and locking clip (on safety belt, if needed). Overall correct CSS use was 20.5%. For infants (children under 20 pounds), 96.6% were in a CSS and 20.6% of the CSSs were correctly used. For toddlers (children between 20 and 40 pounds), 67.5% were in a CSS and 18.9% of the CSSs were correctly used. For pre-school, booster seat weight children (between 40 and 60 pounds), 6.1% were in a CSS and 50% of the CSSs were correctly used. The strongest positive relationship between target child restraint use and CSS proper use was for drivers using safety belts. Other positive relationships were found for the vehicle having air bags, the driver being a family member, the child in the middle back seat position, and CSS infrequently removed from the vehicle. Recommendations are provided for data collection techniques and promoting CSS use and proper use. Data collection should include: local support; train-the-trainer and local workshops; comprehensive classroom and field instruction and supervision; and demonstrations using several CSS makes and types. To improve CSS use and proper use the following are recommended: continue local programs; promote stronger state laws and restraint law enforcement; provide easy to read and understand instructions with CSSs; and conduct periodic CSS misuse surveys. Consideration should be given to CSS and vehicle restraint system design issues that arise from CSS misuse. Research should be conducted to quantify the impact of CSS misuse on children involved in motor vehicle crashes.