title: Motor vehicle crashes associated with alcohol: child passenger injury and restraint use.
abstract: BACKGROUND
  The role of alcohol in fatal motor vehicle crashes involving children has been well established. However, the nonfatal injury burden of alcohol on child passengers has not been comprehensively assessed.
  
  
  OBJECTIVE
  This study sought to determine injury burden and restraint use in child passengers aged 1-15 years in alcohol-related motor vehicle crashes.
  
  
  METHODS
  A retrospective cohort study including all people involved in all crashes with an injury or at least $1000 property damage occurring in Wisconsin in 2007 and involving at least one child passenger aged 1-15 years.
  
  
  RESULTS
  A total of 22,464 child passengers were involved in motor vehicle crashes in Wisconsin in 2007; 2.5% (n=570) were in alcohol-related crashes. Child passengers in alcohol-related crashes experienced twice the risk of injury compared to non-alcohol-related crashes (risk ratio [RR]=2.42, 95% CI=2.08, 2.80). Two-vehicle crashes that were alcohol-related were more than two times more likely to result in child injury than those that were not (RR=2.78, 95% CI=2.30, 3.35). In alcohol-related crashes, the risk of injury in children was higher if they were passengers in the alcohol-related vehicle compared to the non-alcohol-related vehicle (RR=1.35, 95% CI=1.01, 1.79). Inappropriate restraint of child passengers was higher in alcohol-related vehicles (34.5% vs 17.1%, p<0.00005), particularly in the group aged 4-7 years (70.8% vs 44.9% inappropriately restrained).
  
  
  CONCLUSIONS
  Motor vehicle crashes resulting from alcohol-related driving significantly increased child passenger injury and were associated with inappropriate child passenger restraint. Several evidence-based policies are recommended to address this public health problem.
authors.affiliation: Department of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226-0509, USA. aschlott@mcw.edu
authors.forename: Amy E
authors.initials: AE
authors.lastname: Schlotthauer
authors.forename: Clare E
authors.initials: CE
authors.lastname: Guse
authors.forename: Suzanne
authors.initials: S
authors.lastname: Brixey
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Corden
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hargarten
authors.forename: Peter M
authors.initials: PM
authors.lastname: Layde
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000435:Alcoholic Intoxication / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D015370:Infant Equipment; D008297:Male; D012189:Retrospective Studies; D012622:Seat Belts; D014922:Wisconsin; D014947:Wounds and Injuries / Q000453:epidemiology*