title: Teen drivers and the risk of injury to child passengers in motor vehicle crashes.
abstract: OBJECTIVE
  The first aim was to examine the relationship between driver's age (novice teens, older teens, and adults) and child passenger's restraint status, front row seating, and injury risk. The second aim was to explore whether there was an excess injury risk to child passengers in teen crashes compared to those in adult crashes by examining the contributing factors.
  
  
  METHODS
  A cross sectional study involving telephone interviews with insured drivers in a probability sample of 12 163 crashes involving 19 111 children was conducted. Sequential logistic regressions were employed.
  
  
  RESULTS
  Among child passengers aged 4-8, appropriate restraint was <1% for novice teens, 4.5% for older teens, and 23.6% for adults. Front row seating for children <13 years was more common in the novice teen group (26.8%) than in the other two groups. Compared with children riding with adults, those with both teen groups experienced excess injury risk. After adjusting for crash severity, there was a 43% reduction in the odds ratio (OR) for novice teens (OR 1.58, 95% confidence interval (CI) 1.14 to 2.19) and a 24% reduction for older teens (OR 2.15, 95% CI 1.42 to 3.26). After adjusting for vehicle type, child's restraint status and front row seating, there was a further 19% reduction in the OR for novice teens (OR 1.37, 95% CI 1.00 to 1.88) and a further 13% reduction for older teens (OR 1.74, 95% CI 1.14 to 2.66).
  
  
  CONCLUSIONS
  These findings suggest ways in which graduated driver licensing laws may be further enhanced to better protect child passengers from the excess injury risk associated with teen crashes.
authors.affiliation: Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA. cheni@email.chop.edu
authors.forename: I G
authors.initials: IG
authors.lastname: Chen
authors.forename: M R
authors.initials: MR
authors.lastname: Elliott
authors.forename: D R
authors.initials: DR
authors.lastname: Durbin
authors.forename: F K
authors.initials: FK
authors.lastname: Winston
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D001334:Automobile Driving; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D012622:Seat Belts; D017678:Sex Distribution; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control