The effectiveness of child restraint systems for children aged 3 years or younger during motor vehicle collisions: 1996 to 2005.
OBJECTIVE
We estimated the effectiveness of child restraints in preventing death during motor vehicle collisions among children 3 years or younger.


METHODS
We conducted a matched cohort study using Fatality Analysis Reporting System data from 1996 to 2005. We estimated death risk ratios using conditional Poisson regression, bootstrapping, multiple imputation, and a sensitivity analysis of misclassification bias. We examined possible effect modification by selected factors.


RESULTS
The estimated death risk ratios comparing child safety seats with no restraint were 0.27 (95% confidence interval [CI] = 0.21, 0.34) for infants, 0.24 (95% CI = 0.19, 0.30) for children aged 1 year, 0.40 (95% CI = 0.32, 0.51) for those aged 2 years, and 0.41 (95% CI = 0.33, 0.52) for those aged 3 years. Estimated safety seat effectiveness was greater during rollover collisions, in rural environments, and in light trucks. We estimated seat belts to be as effective as safety seats in preventing death for children aged 2 and 3 years.


CONCLUSIONS
Child safety seats are highly effective in reducing the risk of death during severe traffic collisions and generally outperform seat belts. Parents should be encouraged to use child safety seats in favor of seat belts.
Rice
Thomas M
TM
Traffic Safety Center, School of Public Health, University of California, Berkeley, CA 94720-7374, USA. tomrice@berkeley.edu
Anderson
Craig L
CL
D000063:Accidents, Traffic / Q000401:mortality; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000592:standards*; D016012:Poisson Distribution; D011482:Protective Devices / Q000592:standards*; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000517:prevention & control*