Relative benefits of population-level interventions targeting restraint-use in child car passengers.
OBJECTIVE
Because public health resources for injury prevention are limited, methods for comparing competing strategies are needed. We aimed to estimate potential injury reductions for 4 population-level interventions that target restraint practices for child car passengers aged 0 to 12 years.


METHODS
Population-attributable risk fraction (PARF) is a population-level estimate of excess risk from exposure to a risk factor. PARFs were calculated for each intervention scenario by using published age-specific mortality/injury relative-risk estimates; restraint practices among injured child car passengers from police-collected data; and observational data for correctness of restraint use in New South Wales, Australia. PARF reductions were estimated for population uptakes of 25%, 50%, and 75%.


RESULTS
Assuming a 50% population uptake, (1) promoting age-appropriate restraint use could prevent additional fatalities (5.1%, infants; 3.4%, 1- to 6-year-olds) and nonfatal injuries (3.2%, infants; 16.2%, 1- to 6-year-olds) compared with promoting any restraint use; (2) further encouraging correct age-appropriate restraint use could also prevent additional fatalities (9.1%, infants; 14.3%, 1- to 6-year-olds) and nonfatal injuries (9.2%, infants; 10.7%, 1- to 6-year-olds); and (3) for children aged 7 to 12 years, promoting correct use of restraints could prevent an additional 3.4% fatalities and 3.1% nonfatal injuries compared with promoting any restraint use.


CONCLUSIONS
Interventions that target child passenger-restraint practices offer population-level benefits in terms of reduction in fatalities and injuries. These tangible benefits call for action internationally, not only to promote restraint use but correct age-appropriate restraint use for child car passengers.
Du
Wei
W
the George Institute for International Health, University of Sydney, PO Box M201, Missenden Road, New South Wales 2050, Australia. wdu@george.org.au
Finch
Caroline F
CF
Hayen
Andrew
A
Bilston
Lynne
L
Brown
Julie
J
Hatfield
Julie
J
D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data; D001315:Australia; D002648:Child; D057207:Child Restraint Systems; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011634:Public Health; D012307:Risk Factors; D014947:Wounds and Injuries / Q000401:mortality / Q000517:prevention & control*