Use Of Restraint Systems Research Articles

Child passenger fatality: Child restraint system usage and contributing factors among the youngest passengers from 2011 to 2015

Objective: Motor-vehicle crashes (MVC) remain a leading cause of preventable injury and death for children aged 0–3 in the United States. Despite advancement in legislation and public awareness there is continued evidence of inappropriate child restraint system (CRS) use among the youngest passengers. The current study focuses on appropriate CRS use from 2011 to 2015 using data from the Fatality Analysis Reporting System (FARS) for children aged 0–3. Methods: Child-, driver-, vehicle-, and trip-related characteristics were investigated within a sample of 648 children from 625 crashes over 5-years in which a child aged 0–3 was fatally injured while unrestrained or wearing an identified CRS type. Multivariable log-binomial regression was used to obtain relative risk. Results: Only 48% of the fatally injured children were appropriately restrained in a CRS. Premature transition to a booster seat and seat belt was evident. The largest proportion of rear-facing restraint use was reported in <1 year olds (40%), with less reported in 1 (11%) and 2 year olds (2%) and no usage in 3 year olds. Younger children were more likely to be in an appropriate CRS, while Black children, driver not restrained in a lap-shoulder belt configuration, and riding in a pickup truck were less likely to be restrained appropriately. Conclusions: Evidence of inappropriate CRS use supports the use of more stringent legislation and parental interventions to communicate best practice recommendations and educate caregivers regarding appropriate child restraint methods. Practical applications: Public health campaigns focused on increasing appropriate restraint use in children are of great importance as optimally restrained children are less likely to sustain injuries, or require crash-related hospitalization compared to unrestrained children. Researchers and practitioners may find these surveillance findings essential when developing education and interventions targeting child–parent dyads at the greatest risk for a MVC-related fatality.

Current use of safety restraint systems and front seats in Korean children based on the 2008-2015 Korea National Health and Nutrition Examination Survey.

Purpose The use of proper safety restraint systems by children is vital for the reduction of traffic accident-related injury and death. This study evaluated the rates of use of safety restraint systems and front seats by Korean children.Methods Based on data from the National Health and Nutrition Examination Survey from 2008 to 2015, I investigated the frequencies of safety restraint systems and front seat use by children under six and 12 years of age, respectively.Results The percentage of respondents who said they always use safety restraint systems increased from 17.7% in 2008 to 45.0% in 2015. The rate of children who did not use the front seats at all was 47.3 % in 2008 compared to 33.4% in 2015. Multivariate logistic regression analysis showed a decrease in safety-restraint-system use as age increased (odds ratio, 0.63; 95% confidence interval [CI], 0.51–0.77). The use rate of front-passenger seat belts by the mother is significantly correlated with the safety-restraint- system use rate by children (odds ratio, 2.14; 95% CI, 1.12–4.06).Conclusion Although the rate of safety-restraint-system use for children is increasing annually, it remains low. Additionally, the use rate of front passenger seats for children is high. To reduce the rates of injury and death of children from traffic accidents, it is necessary to educate on the appropriate use of safety restraint systems according to age and body size and to develop stronger regulations.

Factors Associated with Cell Phone Use While Driving: A Survey of Parents and Caregivers of Children Ages 4-10 Years

To examine characteristics associated with cell phone use while driving by parents and caregivers of children ages 4-10 years. National cross-sectional online survey with a convenience sample (March 2017-April 2017). Parent/caregiver of a child age 4-10 years in their home, age ≥18 years, read and spoke English, and drove child ≥6 times in previous 3 months. Adjusted logistic regression analyses were modeled for outcome measures of previous 3-month self-report cell phone use while driving with the child. The analytic sample was n = 760. In the previous 3 months, 47% of parent/caregivers talked on a hand-held phone, 52.2% talked on a hands-free phone, 33.7% read texts, 26.7% sent texts, and 13.7% used social media while driving with their child in the vehicle. Compared with those who always used their typical child restraint system, participants who did not always use were more likely to talk on a hands-free phone (aOR 1.97, 95% CI 1.26-3.09), read a text (aOR 1.74, 95% CI 1.11-2.73), send a text (aOR 1.65, 95% CI 1.04-2.62), and use social media (aOR 2.92, 95% CI 1.73-4.94) while driving. Higher income, not wearing a seat belt (driver) on every trip, and driving under influence of alcohol also were associated with various types of cell phone use while driving. Inconsistent child restraint system use, lack of seat belt use, and driving under the influence of alcohol are associated with parent/caregiver cell phone use while driving. Screening and education related to parental driving behaviors should include addressing multiple risk behaviors.

Factors Associated With Child Restraint Use in Motor Vehicle Crashes.

Motor vehicle crashes (MVCs) are a leading cause of death among children. Multivariable analyses of age-appropriate child restraint system (CRS) use in the "booster-aged" population are needed. The current study identified factors associated with age-appropriate CRS use in fatal MVCs for children 4 to 7 years old, using 2011 to 2015 data from the Fatality Analysis Reporting System. Of 929 MVC fatalities, 32% of fatally injured children were in an age-appropriate restraint. While age-appropriate CRS use was higher for 4-, 5-, and 6-year-olds relative to 7-year-olds (adjusted relative risk [aRR] = 2.57, 2.51, and 2.18, respectively; p < .01 for each comparison), black children (aRR = 0.62; p < .01) relative to white children, and drivers who had not used a lap-shoulder belt (aRR = 0.40; p < .01) relative to belted drivers were associated with lower levels of age-appropriate CRS use. Our findings underscore the continued importance of communicating best practice guidelines on CRSs to caregivers of young children.

Child restraint system use in the United Arab Emirates

ObjectiveDeaths and injuries among infants due to traffic crashes in the United Arab Emirates (UAE) are very high when compared to other countries. An efficient way to improve the safety of children in moving vehicles is to use Child Restraint Systems (CRS) to hold the child during any possible collision. The aim of this study is to estimate the rate of CRS use among children under the age of five in UAE, to determine demographic characteristics that affect CRS use, such as parent’s age, and education level, and to assess parents’ perceptions and knowledge of this issue. MethodsA roadside observational study was done in two of the seven emirates that constitute UAE, involving 1000 randomly taken observations. Also, a questionnaire was randomly distributed to a sample of 494 parents of children under the age of five. ResultsResults of the observational study show that 16.7% of parents restrain their children in moving motor vehicles. Questionnaire results show that approximately 9% of respondents reported not or rarely restraining their children in moving motor vehicles. Also, 3.4% of them indicated their disbelief in the importance of CRS in reducing harm in case of a crash. Moreover, questionnaire results indicate that young, less educated and male parents reported lower use rate and have less belief in the importance of CRS use in harm reduction in crashes than other groups of parents. ConclusionsCRS use in UAE is very low and awareness of its importance needs to be improved. Based on the results, practical suggestions are put forward to increase CRS use rate and improve safety conditions for this group of road users.

Analysis of the Improper Use or Non-Use of Child Restraint Systems in Private School Transport. Identification of Erroneous Behaviours

Segun cifras del ERSO, los accidentes de trafico son la primera causa de mortalidad de menores de 0 a 14 anos en Europa. Dentro de este grupo existe un 42% de menores muertos en accidentes que viajaban y que no utilizaban ni el sistema de retencion infantil ni el cinturon de seguridad. El estudio consistio en un cuestionario on-line (distribuido por Comunidades Autonomas proporcionalmente en funcion del numero de habitantes) y un estudio de observacion (Madrid, Barcelona, Valencia, Sevilla y Vizcaya) que se paso respectivamente a 605 y 411 conductores de coche y furgoneta que transportaban ninos entre 0 y 12 anos. Entre un 3% y un 7% de los encuestados transportan a los ninos sin el sistema de retencion infantil. Estos porcentajes de no uso de sistemas de retencion infantil corresponden mas a hombres, menores de 30 o mayores de 50 anos, durante trayectos cortos, que transportan a los ninos con baja frecuencia, que ademas no disponen de SRI y si disponen de ellos creen que con el cinturon de seguridad es suficiente.

Has Child Restraint System Use Increased among Parents of Children in Shantou, China?

Objective: to examine parents’ use of child restraint systems (CRS), and determine if parents’ knowledge of, attitude toward, and use behavior of child restraint systems have improved following enactment of child restraint use laws in other cities. Design: Observations and a cross-sectional survey of drivers transporting children 17 years and under were conducted at the gate of the schools and parking lots of hospitals in Shantou. Observers recorded the seating location of child passengers, the type of restraint, and appropriate use of CRS and safety belts based on the observation. Knowledge of and attitudes towards use of CRS were reported by the driver following observation. Results: Approximately 6.6% of passengers aged 0–12 were in CRS; rate of forward-facing CRS in children aged 3–5 (9.9%) was higher than rear-facing CRS for children aged 0–2 (1.1%) and booster seat use among children aged 6–12 (0.1%). Children younger than four years old (OR = 3.395, 95% CI = 2.125–5.424), drivers having a college or higher lever education (OR = 2.908, 95% CI = 1.878–4.500) and drivers wearing seatbelt (OR = 3.194, 95% CI = 1.605–6.356) had greater odds of CRS use. Over half (56.6%) of parents might or would use CRS if they could rent CRSs with fees. Conclusions: The rate of CRS is still low in Shantou. Comprehensive public education programs supported by legislation might be an effective way to improve child passenger safety. Renting CRSs to parents could be a new approach to encourage use.

PO18 – Safety road for children: knowledge and attitudes of parents in the use of child restraint systems

Theme: Child protection and managing risk. BACKGROUND: Correct use of a restraint system for children (CRS) from birth is an effective form of protection. OBJECTIVES: To characterize parent's knowledge and attitudes in using CRS. METHODS: Cross-sectional study, held in a non-probabilistic sample of 112 parents of newborns, mothers mean age 30.37 years old (SD = 5.63). Parents completed a questionnaire, 24-48 hours after baby birth in Obstetrics and Neonatology services of a public hospital in Portugal. RESULTS: Mothers mostly had secondary level of education. In 54.5% CRS was part of the 'layette baby' and, of these, 72.3% had already experimented it in the car. Only 15.2% reported having had training by nursing team during pregnancy. 97.3% intended to use the CRS, however only 47.3% would do it adequately. All recognize that CRS prevents serious injury, and 67% reported adequate knowledge. CONCLUSIONS: Results indicate that knowledge and parental attitudes about the proper use of CRS remains insufficient. Language: en

The effect of including a fetus in the uterus model on the risk of fetus mortality through drop test and frontal crash simulations

ABSTRACTComputational modelling is an effective way of estimating the risk of injuries and fatalities in road traffic accidents. Computational pregnant occupant modelling has an additional important role in the investigation of the risk of fetus mortality in crash test simulations. In this paper, the effect of including the fetus in the uterus of the pregnant occupant model is investigated. First, isolated drop test simulations with the uterus of the computational pregnant occupant model, ‘Expecting’, with and without a fetus are used to show the effect of the presence of fetus in the uterus model. Then ‘Expecting’ with and without the fetus is used with varying levels of restraint system use, such as fully restrained, ‘seatbelt only’, ‘airbag only’ and ‘no restraint’, in frontal crash simulations, representing five levels of impacts. Maximum strains developed in the uteroplacental interface with and without a fetus are compared in every case. Both simulations predict higher risks of placental abruption when the fetus is included in the model. Simulations with and without a fetus model show that inclusion of a 38-week fetus model causes higher strains in the placental region of uterus.

Analysis on influencing factors for child restraint system use in Shanghai and Shenzhen, China

To understand the factors related with child restraint system (CRS) use, and provide evidence for the development of appropriate intervention measures to promote the use of CRS for the protection of child passengers' safety. Self-administrated questionnaire survey was conducted among 0-6 years old children's parents who owned private cars selected through stratified cluster random sampling in Shanghai and Shenzhen to collect date about CRS use and related factors. Group discussion was conducted among some of the parents randomly selected to further understand the reasons for using or not using CRS. Of 7528 parents surveyed, 39.23% (2820/7189) reported to have CRS and 17.14% (1232/7189) reported consistent use of CRS. Multivariate analysis indicated that young age of children, high level of education of parents, good family economic status, awareness of importance of children's safety were the positive factors for CRS use. The frequency and distance of children'car taking and the seatbelt use of drivers significantly influenced the CRS use. The main reasons for not purchasing CRS included limited car space (53.33%, 2329/4 367), low frequency of children car taking (48.55%, 2120/4367), difficulty in installation (42.25%, 1845/4367), high cost (38.58%, 1685/4367), and unreliable quality (31.03%, 1355/4367). The main reasons for not using CRS included children's refusal (67.36%, 293/435), short travel distance (53.79%, 234/435), difficulty in installation or use (53.10%, 231/435), limited car space (32.41%, 141/435), and unnecessary (25.75%, 112/435). Parents have gaps and misunderstandings in using CRSs to protect child passengers safety. There are demands of technical guiding service in use of CRS. Integrated intervention measures should be implemented targeting at the identified barriers and needs in CRS use to promote child passenger safety, which include strengthening the propaganda and education, promoting the legislation and law enforcement, strengthening market supervision, establishing CRS related services site, exploring the rental market, etc.

Road Safety Barriers, the Need and Influence on Road Traffic Accidents

Constantly increasing intensity of road traffic and the allowed speed limits seem to impose stronger requirements on road infrastructure and use of road safety systems. One of the ways to improve road safety is the use of road restraint systems. Road safety barriers allow not only reducing the number of road traffic accidents, but also lowering the severity of accidents. The paper provides information on the technical requirements of road safety barriers. Various types of road safety barriers and their selection criteria for different types of road sections are discussed.The article views an example of a road traffic accident, which is also modelled by PC-Crash computer program. The given example reflects a road accident mechanism in case of a car-to-barrier collision, and provides information about the typical damage to the car and the barrier. The paper describes an impact of the road safety barrier type and its presence on the road traffic accident mechanism. Implementation and maintenance costs of different barrier types are viewed. The article presents a discussion on the necessity to use road safety barriers, as well as their optimal choice.

The Prevalence of Child Restraint System Use among Children in Vehicles Equipped with Front Passenger Airbag in Kajang, Malaysia

New cars are being introduced with front passenger airbags (PAB) as a standard safety feature. Airbags are designed to reduce vehicle occupant injury in the event of a collision. In order for airbags to be effective, occupants must be restrained while travelling in vehicles. Children are often seen unrestrained while travelling in vehicles throughout Malaysia. Studies have shown that unrestrained children are exposed to higher risk of injury in a crash involving PAB deployment, compared to those who are restrained. The intended life saving benefit of PAB may be negated if child occupants remain mostly unrestrained. The objective of the study is to determine the prevalence of child restraint system (CRS) use in vehicles, especially those equipped with PAB. To realise this, an observational survey was conducted at selected day care centres in Kajang, to determine the use of child restraints among children aged six and below, child seating position, driver seatbelt use and availability of PAB. The study was performed in the first half of 2012. A total of 537 children aged 6 and below were observed. 51.4% of the children were seated in the front passenger seat, 45.3% were seated in the rear and 3.3% were seated on the driver’s lap. 13.3% of children seated in front seats were restrained, compared to 4.9% of those seated at the rear. Children were 4 times more likely to be restrained if the drivers were belted compared to those who were not. In vehicles equipped with PAB, 11.2% of children seated on the front seats are restrained, while in vehicles without, 17.1% were restrained. The restraint use among children is low and the presence of PAB does not have a significant effect on the use of CRS. There was a significant association between belted drivers and restrained children. The low CRS use is expected as the current legislation does not specifically mention the requirement for children to use CRS while travelling in vehicle, even if the vehicle is equipped with PAB.

National roadside survey of child restraint system use in Belgium

In September 2011 the Belgian Road Safety Institute (BRSI) conducted its first roadside survey of child restraint system (CRS) use and misuse. The aim of this study was to obtain population-bases estimates of the prevalence of use and misuse of CRS and to identify predictors of misuse on the basis of observations in real traffic conditions. The survey was conducted on randomly selected sites across the country, stratified across various types of journeys. The principal parameters analysed were: the characteristics of the children and the car drivers, type of journey, types of CRS and types of misuse. The sample consisted of 1461 children (under 135cm) for whom the conditions of restraint were observed in detail and the driver was interviewed.At least 50% of the children were not correctly restrained and 10% were not restrained at all. The most significant factors associated with CRS use were the use of a seatbelt by the driver (31% of unrestrained children for unbelted drivers, compared to 7% for belted drivers - only 32% of correctly restrained children for unbelted drivers compared to 54% for belted drivers), whether the CRS was bought in a specialized shop (only 27% of misuse compared to 45% of misuse for CRS both in supermarkets) and the age of the children. The proportion of correctly restrained children (appropriate without misuse, the bottom category in the figure) has a roughly curvilinear relation with age; decreasing from 75% at age 0 to 24% at age 8 and going back up to 63% at age 10. Although the sample of ISOFIX users was small (n=76), it appears that the ISOFIX system reduced misuse significantly.Most of the drivers were ignorant of their own errors concerning the inappropriateness and/or misuse of the CRS or they were remiss and underestimated the risk. The three main reasons given by the drivers to explain or justify the misuse noticed were: low attention level to safety (inattention, time pressure, and short distance), the child's resistance to be restrained, children restraining themselves and problems with the CRS. The present results suggest little or no change in the level of correct CRS use over the last five years and clearly reveal the unacceptably high levels of incorrect and/or inappropriate CRS use. This calls for campaigns and other actions to inform and motivate the population.

Dementia special care units: a comparison with standard units regarding residents’ profile and care features

Unlike other countries, no data about residents and care features in Special Care Units (SCUs) in Spanish nursing homes have been reported to date. The present paper is the first to analyze the characteristics of residents with dementia and the features of provided care in SCUs in comparison to residents with dementia in standard beds, thus not receiving specialized care in nursing homes in Spain. Data on residents with dementia were collected in 11 nursing homes. Residents with diagnosis of dementia and Mini-Mental State Examination scores of less than 27 were randomly selected in each center. Altogether 197 residents were assessed: 102 (52%) placed in SCUs, and 95 (48%) in standard beds. Analyses of the characteristics of residents in SCUs versus standard beds regarding socio-demographic and clinical variables, features of the care provided, and residents' quality of life (QoL) were performed using univariate and multivariate tests (binary logistic regression analysis). Residents in SCUs did not differ from those in standard beds in socio-demographic variables. Placement of residents in SCUs seemed to be related with the presence of severe cognitive and functional impairment and aggressive behaviors. Being in an SCU conveyed a higher probability of having individual bedroom and bathroom; nevertheless, there were no differences in the care provided in SCUs, considering use of nappies, and feeding and restraint systems. Patients in SCUs showed lower QoL reported by the staff. Although residents in SCUs present higher levels of impairment, there are no real differences in the care provided besides a higher probability of having individual rooms. Regulations on required features for SCUs in Spain are necessary to guarantee that care provided to residents is truly special.

Performances evaluation of a PET/CT device for treatments virtual simulation in radiotherapy

Introduction The Big Bore PET/CT is the model which offers the widest opening of tunnel (a diameter of 85 cm) due to the absence of external septa. The use of bulky restraint systems like those used in radiotherapy is possible. Therefore the Big Bore is presented like the PET/CT dedicated to virtual simulation of radiation treatment. Few studies have been conducted on performances evaluation of the PET/CT Big Bore. Besides, none bears to pay particular attention to the absence of external septa. The purpose of this study is to compare the Big Bore performances to the standard model TF 16, used as a reference in this work, to assess the impact of the tunnel enlargement on the quantification and the target volumes definition in radiotherapy. Meanwhile, this study offers to carry out new tests, more specific to the characteristics of the PET/CT Big Bore. Material and methods The Big Bore is composed of 28336 crystals of 4 × 4 × 22 mm 3 Cerium doped Lutetium Yttrium Orthosilicate (LYSO) spread over 44 rings of 90 cm diameter. Wide bore opening is 85 cm. The axial (〚FOV〛_ax) and transverse (〚FOV〛_tr) fields of view axial are 18 cm and more than 67.6 cm, respectively. It doesn't have any septa and can operate in 3-dimensional (3D) mode. The coincident window width is 3.8 ns. The energy is greater than 440 keV. The electronic system allows using the Time Of Flight (TOF). The CT scanner is the Brillance 16 slice. In comparison, PET/CT Gemini TF 16 has same characteristics except a wide bore opening of 70 cm because of presence of external septa of 7.5 cm. The performances of both PET/CT are evaluated using ‘‘classical” experiments found in literature: the NEMA NU 2-2007 Protocol, measurement of intrinsic radioactivity from LYSO and evaluation of temporal and energy resolutions. The original experiment, created for this work, consists on assessment of an external radioactivity source influence, over multiple distances, on the image quality of test phantom. Results The preliminary results of the first experiment underline that the absence of external septa has an influence on the image quality. Carrying out other experiments would permit to characterize the phenomenon in depth. Conclusion This study proposes the performances evaluation of the Big Bore. Results of the different experiments are being processed and will be presented.

Automobile Safety in Children: A Review of North American Evidence and Recommendations

In the United States, the rate of vehicle occupant deaths in children aged 1 to 3 years has decreased by over 50% in the past three decades. However, the Centers for Disease Control and Prevention report that motor vehicle crashes remain the leading cause of death in children aged 1 to 17 years. Parental compliance with child safety seats is poor, with up to 99% of children in certain age groups improperly restrained. Epidemiologic data support the proper use of automobile restraint systems to save lives. When appropriate restraint systems (based on age and weight) are used, a significant decrease occurs in the rates of mortality and serious injury. Legislation and public service campaigns can increase awareness regarding appropriate use of automobile restraint systems to decrease pediatric injury and fatality rates. Fluency and awareness, rather than cost, have been found to be the main reasons for improper use of automobile restraint systems; appropriately targeted education programs should continue to be developed. Physicians are optimally poised to educate patients and parents about automobile safety.

Child Restraint Safety Practices Among Arab Children in Israel

Objective: Because the rate of injury and mortality from car crashes among Arab children is higher than among Jewish children in Israel, this study assesses the patterns of age-appropriate child restraint system (CRS) use in Arab towns in Israel. Methods: From October 2010 to September 2011, 4396 children ages 0 to 14 were observed while seated in vehicles in 9 Arab towns and villages in Israel. Results: Among infants aged 0 to 1 year old, 31.2 percent were observed in an age-appropriate restraint, whereas among children aged 1 to 4 years, only 12.4 percent were age-appropriately restrained. Children aged 5 to 9 were observed to have the lowest levels of age-appropriate restraint use (1.3%). The variation between the various villages was large and dependent on the age of the child. Conclusions: The low rates of CRS use may explain to some degree the high rates of injury and mortality of Arab children in car crashes. These low rates indicate that previous interventions have not been successful in increasing restraint use in the Arab community in Israel and there is a need to plan targeted interventions specifically for this population. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Fracturas en la atrofia muscular espinal

To determine the frequency of fractures in patients with spinal muscular atrophy, their mechanism of production, age at appearance and functional repercussions. Sixty-five patients with spinal muscular atrophy were studied. Cases of fractures diagnosed by means of X-rays were collected and the following parameters were analysed: type of spinal muscular atrophy, gait, age at the time the fracture occurred, mechanism of production, location, treatment applied and functional repercussion. Thirteen patients (20%) presented a total of 20 fractures (four of them presented two or more fractures). The mean age was 6.35 years. The fractures were mostly located in the femur and the mechanism of production was falls in 12 cases and minor traumatic injury in eight. No vertebral fractures were detected. All of them were treated conservatively. The only patient with a fracture who was able to walk stopped walking after immobilisation. The existence of fractures in these patients interferes with their quality of life and their level of functioning. It is important to prevent them from occurring during management of the patient and by ensuring a correct posture in the wheelchair with the use of restraint systems. Further studies are needed on the loss of bone mineral density in these patients and their possible relationship with fractures.

Parents’ attitudes, knowledge and behaviours relating to safe child occupant travel

This study investigated parents’ attitudes, knowledge and behaviours relating to safe child occupant travel following new Australian legislation regarding child restraint system (CRS) and motor vehicle restraint use for children aged 7 years and under. A questionnaire exploring attitudes, knowledge and behaviours regarding general road safety, as well as safe child occupant travel, was completed by 272 participants with at least one child aged between 3 and 10 years residing in the Australian state of Victoria. Responses to the questionnaire revealed that participants’ attitudes, knowledge and behaviours towards road safety in general were fairly positive, with most participants reporting that they restrict their alcohol consumption or do not drink at all while driving (87%), drive at or below the speed limit (85%) and ‘always’ wear their seatbelts (98%). However, more than half of the participants reported engaging in distracting behaviours ‘sometimes’ or ‘often’ (54%) and a small proportion of participants indicated that they ‘sometimes’ engaged in aggressive driving (14%). Regarding their attitudes, knowledge and behaviours relating to safe child occupant travel, most participants reported that they ‘always’ restrain their children (99%). However, there was a surprisingly high proportion of participants who did not know the appropriate age thresholds’ to transition their child from a booster seat to an adult seatbelt (53%) or the age for which it is appropriate for their child to sit in the front passenger seat of the vehicle (20%). Logistic regression analyses revealed that parents’ knowledge regarding safe child occupant travel was significantly related to their attitudes, knowledge and behaviours towards road safety in general, such as drinking habits while driving and CRS safety knowledge. Based on the findings of this study, a number of recommendations are made for strategies to enhance parents’ attitudes, knowledge and behaviours relating to safe child occupant travel, as well as for future research.

Low rates of child restraint system use in cars may be due to fatalistic beliefs and other factors

Restraining children in cars has proven to save lives during car crashes. However, not all drivers of cars with children in them comply with the law regarding child restraint system (CRS) use. The aim of this study was to measure the rate of child and adult CRS use and to identify associations between fatalistic beliefs and CRS use among Arab children. A random sample of 380 Arab drivers transporting children 8 years and younger in Israel were interviewed after observing 835 children traveling in 400 vehicles. Proper restraint ranged from 41% among children aged one to three to 9% among booster seat-eligible children. In a logistic regression model driver seat belt use, fatalistic beliefs, knowledge regarding the law on CRS, number of children in the car, age and gender were associated with all the children being restrained in the car. Drivers with higher levels of fatalistic beliefs had a lower odds ratio of restraining their children in the car, after adjusting for the other confounding variables (OR = 0.80, CI = 0.65, 0.97). High levels of fatalism and low levels of knowledge in addition to other factors may inhibit Israeli Arab parents from restraining their children in cars. Therefore, children in these communities are at risk of injury or death in motor vehicle crashes and there is a need for tailored interventions specific for this population.