title: Association between child restraint systems use and injury in motor vehicle crashes.
abstract: OBJECTIVE
  The objective was to estimate the fatal and nonfatal injury risk associated with inappropriate or no use of child restraint systems (CRS) for children younger than 13 years of age involved in motor vehicle crashes (MVC) in the United States.
  
  
  METHODS
  This was a cross-sectional study of children aged 0 to 12 years involved in MVCs based on a nationally representative probability sample from 1996 to 2005 in the United States. A total of 7,633 children were included in the analysis, weighted to represent 3,798,830 children. Logistic regression models were used to examine the association between restraint use and fatal or nonfatal injury.
  
  
  RESULTS
  In all age groups, failure to use a restraint increased the risk of fatal injury (odds ratio [OR] ranged from 9.81 to 23.79, all p < 0.05). In children aged 1 to 3 years, inappropriate use of a restraint was associated with fatal injury (OR = 6.28, 95% confidence interval [CI] = 2.40 to 16.48). Restrained children aged 4 to 7 years in rear seats with seat belts only (OR = 0.33, 95% CI = 0.11 to 0.94) and infants in front seats using child safety seats (OR = 0.26, 95% CI = 0.07 to 0.99) were associated with decreased nonfatal but not fatal injury compared to children with the recommended use of CRS in the two age groups.
  
  
  CONCLUSIONS
  Failure to use child restraints was associated with increased fatal injury. Our findings raise questions regarding current recommendations for specific CRS use in infants and children 4 to 7 years old. Further research is needed to identify the most effective CRS and seating location for children of each age.
authors: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors: Xiaoguang
authors: X
authors: Ma
authors: Peter
authors: P
authors: Layde
authors: Shankuan
authors: S
authors: Zhu
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data*; D002648:Child; D057207:Child Restraint Systems / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012306:Risk; D012622:Seat Belts / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control