title: Effect of seating position and restraint use on injuries to children in motor vehicle crashes.
abstract: OBJECTIVE
  To determine the effect of restraint use and seating position on injuries to children in motor vehicle crashes, with stratification by area of impact.
  
  
  METHODS
  Children <15 years old involved in serious automobile crashes in Utah from 1992 through 1996 were identified from statewide motor vehicle crash records. Serious crashes are defined as those resulting in occupant injuries with broken bones or significant bleeding or property damage exceeding $750. Probabilistic methods were used to link these records with hospital records. Analysis used logistic regression controlling for age, restraint use, occupant seating position, and type of crash.
  
  
  RESULTS
  We studied 5751 children and found 53% were rear seat passengers. More than 40% were unrestrained. Sitting in the rear seat offered a significant protective effect (adjusted odds ratio: 1.7; 95% confidence interval: 1.6-2.0), and restraint use enhanced this effect (adjusted odds ratio: 2.7; 95% confidence interval: 2.4-3.1). Mean hospital charges were significantly greater for front seat passengers.
  
  
  CONCLUSIONS
  Rear seat position during a motor vehicle crash provides a significant protective effect, restraint use furthers this effect, and usage rates of restraint devices are low. The rear seat protective effect is in addition to and independent of the protection offered from restraints.
authors.affiliation: Divisions of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, USA. marc.berg@hci.utah.edu
authors.forename: M D
authors.initials: MD
authors.lastname: Berg
authors.forename: L
authors.initials: L
authors.lastname: Cook
authors.forename: H M
authors.initials: HM
authors.lastname: Corneli
authors.forename: D D
authors.initials: DD
authors.lastname: Vernon
authors.forename: J M
authors.initials: JM
authors.lastname: Dean
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D015370:Infant Equipment; D007231:Infant, Newborn; D016015:Logistic Models; D011482:Protective Devices; D018570:Risk Assessment; D014947:Wounds and Injuries / Q000209:etiology / Q000517:prevention & control*