Restraint Factors and Child Passenger Deaths in New South Wales, Australia.

Tom Whyte,Bianca Albanese,Jane Elkington,Julie Brown,Lynne Bilston

doi:10.3390/ijerph17041147

Abstract

Inappropriate or incorrect use of child restraints can influence crash injury outcome. This study examined the role of restraint factors in child passenger deaths and the effect of legislation requiring appropriate restraint systems up to 7 years old. Data for child (0–12 years) passenger deaths occurring in New South Wales (NSW) from 2007 to 2016 were collected by the child death review team including photographs, reports of in-depth crash investigation, witness reports and medical reports. Restraint use, type of restraint, appropriateness of the restraint for the age of the child and correctness of restraint use were examined. The primary contributor to death was determined in each case. Sixty-four child passengers died in NSW during the data period. Twenty-nine (29/64, 45%) were properly restrained. Thirteen children (13/64, 20%) were unrestrained. In 20 cases (20/64, 31%), children were using a restraint that was either inappropriate for their age (6) or not used correctly (14). Restraint factors were a primary contributor in 22 (22/64, 34%) child deaths. Compared to pre-legislation, appropriate restraint use was more common post-legislation (13/22. 59% vs. 30/42, 71%). However, incorrect use was also greater (3/22, 14% vs. 11/42, 26%). Interventions targeting increasing restraint use and reduction of common ‘use’ errors are needed to prevent further restraint factor-related deaths.

Highlights

Injury is the leading cause of death and a major contributor to hospitalisations among children older than one year in Australia and developed countries [1,2,3]
Child passengers in motor vehicle crashes account for approximately 50% of transport-related injury in high-income countries [3]
The aim of this study was to use the in-depth detailed data provided in the child death review team (CDRT) dataset to examine the role of restraint factors such as non-use, inappropriate restraint for the child’s size and incorrect use of restraints in child passenger deaths in New South Wales (NSW) over a ten-year period (2007–2016)

Summary

Introduction

Injury is the leading cause of death and a major contributor to hospitalisations among children older than one year in Australia and developed countries [1,2,3]. A large proportion of these injuries are related to transport. Child passengers in motor vehicle crashes account for approximately 50% of transport-related injury in high-income countries [3]. The most effective way to reduce the risk of injury in a motor vehicle crash is to restrain the occupant in the vehicle [4,5,6]. Suboptimal restraint of children is associated with more serious injuries in the event of a crash [7,8] and has previously been reported to be common among both children admitted to hospital following a crash [7,8] and the general population of children travelling in cars [9]

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