Belt-positioning Booster Seats Research Articles

Child and family safety device affordability by country income level: an 18 country comparison

Objective: To compare availability, urban price, and affordability of child/family safety devices between 18 economically diverse countries. Design: Descriptive: urban price surveys by local safety organisations or shoppers. Setting: Retail...

Recent trends in child restraint practices in the United States.

To assess the success of recent outreach activities to promote appropriate child restraint in motor vehicles by examining trends in restraint types used by children under age 9 in 3 large regions of the United States. Cross-sectional study was conducted of children who were under age 9 and in crashes of insured vehicles in 15 states, with data collected via insurance claims records and a telephone survey. A probability sample of 8730 crashes involving 10,195 children, representing 128 291 crashes involving 149,820 children, was collected between December 1, 1998, and November 30, 2002. Parent report was used to determine restraint type used in the crash. Logistic regression models were used to analyze the secular trend of restraint type use. Overall, for children under age 9, seat belt use decreased significantly from 49% to 36% between 1998 and 2002; for 7- and 8-year-olds, from 97% to 92%; and for 3- to 6-year-olds, from 63% to 34%. Concurrently, gains were achieved in overall child restraint use from 49% to 63%, for 7- and 8-year-olds, from 2% to 5%; and for 3- to 6-year-olds, from 35% to 65%. Child restraint use remains stable for children from birth to 2 years of age (from 97% in 1998 to 98% in 2002). Both the use of child safety seat and belt positioning booster seat increased significantly, whereas shield booster seat use decreased significantly. Although considerable achievements have been realized over a short period of time, substantial inappropriate restraint still remains: 62% of children aged 4 to 8 remain inappropriately restrained in adult seat belts. Parents hear safety messages when they are relevant to their children. As a result, sustained efforts about appropriate restraint must continue to maintain and improve the gains achieved in appropriate child restraint use. The additional benefits realized by recent changes in child restraint laws remain to be evaluated.

Belt-positioning booster seats and reduction in risk of injury among children in vehicle crashes

Durbin DR, Elliott MR, Winston FK (Children's Hospital of Pennsylvania, Philadelphia, PA) More than 12 states have ratified laws that require booster seats for children older than 4 years of age. Most states have restraint laws that address children through age 4 years. The lack of booster seat effectiveness data may be why stronger child restraint laws have not been passed. The relative effectiveness of belt-positioning booster seats versus seat belts alone in decreasing the risk of injury to children aged 4 to 7 years was examined in a cross-sectional investigation. Children aged 4 to 7 years involved in crashes of insured vehicles in 15 states were evaluated. The data were obtained from insurance claims records and a telephone survey. A probability sample of 3,616 crashes involving 4,243 children, weighted to represent 56,593 children in 48,257 crashes, was obtained between December 1, 1998, and May 31, 2002. Analyses were performed to compute the relative risk of injury for children aged 4 to 7 years who were restrained in belt-positioned booster seats versus seat belts. The primary outcome measure was parent report of clinically significant injuries. Restraint use varied by age. Seat belts were used in 42% of 4-year-olds, 72% of 5-year-olds, and 89% of 6- and 7-year-olds. The belt-positioning booster seats were used in 16% of 4-year-olds, 13% of 5-year-olds, and 4% of 6- and 7-year-olds. Injuries occurred in 1.18% of 4- to 7-year-olds, including 1.95% of those in seat belts and 0.77% of those in belt-positioning booster seats. There were 5 deaths among children in seat belts and none in children in belt-positioning booster seats. The odds of injury, adjusted for child, driver, crash, and vehicle characteristics, were 59% lower for children aged 4 to 7 years who were in belt-positioning booster seats versus those in seat belts (odds ratio 0.41; 95% confidence interval 0.20 to 0.86). Children in belt-positioning booster seats had no injuries to the abdomen, neck/spine/back, or lower extremities. Children in seat belts had injuries to all body regions. Children in seat belts were more likely to be in vehicles driven by young drivers and more likely to be situated in the front seat. Children in belt-positioning booster seats were more likely to be positioned in the rear seats. Belt-positioning booster seats were linked to added safety benefits compared with seat belts for children aged 4 to 7 years, including a decrease in injuries classically linked to improper seat belt fit for children.

Belt-Positioning Booster Seats and Reduction in Risk of Injury Among Children in Vehicle Crashes

Although more than a dozen states have ratified laws that require booster seats for children older than 4 years, most states continue to have child restraint laws that only cover children through age 4 years. Lack of booster seat effectiveness data may be a barrier to passage of stronger child restraint laws. To quantify the association of belt-positioning booster seats compared with seat belts alone and risk of injury among 4- to 7-year-old children and to assess patterns of injury among children in booster seats vs seat belts. Cross-sectional study of children aged 4 to 7 years in crashes of insured vehicles in 15 states, with data collected via insurance claims records and a telephone survey. A probability sample of 3616 crashes involving 4243 children, weighted to represent 56 593 children in 48 257 crashes was collected between December 1, 1998, and May 31, 2002. Parent report of clinically significant injuries. Injuries occurred among 1.81% of all 4- to 7-year-olds, including 1.95% of those in seat belts and 0.77% of those in belt-positioning booster seats. The odds of injury, adjusting for child, driver, crash, and vehicle characteristics, were 59% lower for children aged 4 to 7 years in belt-positioning boosters than in seat belts (odds ratio, 0.41; 95% confidence interval, 0.20-0.86). Children in belt-positioning booster seats had no injuries to the abdomen, neck/spine/back, or lower extremities, while children in seat belts alone had injuries to all body regions. Belt-positioning booster seats were associated with added safety benefits compared with seat belts to children through age 7 years, including reduction of injuries classically associated with improper seat belt fit in children.

Misuse of booster seats

Objective—To describe several aspects of booster seat use and misuse in a sample of children attending child safety seat clinics. Methods—Booster seat practices were assessed at 76 child safety seat...