title: Booster seat laws and fatalities in children 4 to 7 years of age.
abstract: OBJECTIVE
  To determine whether state booster seat laws were associated with decreased fatality rates in children 4 to 7 years of age in the United States.
  
  
  METHODS
  Retrospective, longitudinal analysis of all motor vehicle occupant crashes involving children 4 to 7 years of age identified in the Fatality Analysis Reporting System from January 1999 through December 2009. The main outcome measure was fatality rates of motor vehicle occupants aged 4 to 7 years. Because most booster laws exclude children 6 to 7 years of age, we performed separate analyses for children 4 to 5, 6, and 7 years of age.
  
  
  RESULTS
  When controlling for other motor vehicle legislation, temporal and economic factors, states with booster seat laws had a lower risk of fatalities in 4- to 5-year-olds than states without booster seat laws (adjusted incidence rate ratio 0.89; 95% confidence interval [CI] 0.81-0.99). States with booster seat laws that included 6-year-olds had an adjusted incidence rate ratio of 0.77 (95% CI 0.65-0.91) for motor vehicle collision fatalities of 6-year-olds and those that included 7-year-olds had an adjusted incidence rate ratio of 0.75 (95% CI, 0.62-0.91) for motor vehicle collision fatalities of 7-year-olds.
  
  
  CONCLUSIONS
  Booster seat laws are associated with decreased fatalities in children 4 to 7 years of age, with the strongest association seen in children 6 to 7 years of age. Future legislative efforts should extend current laws to children aged 6 to 7 years.
authors.affiliation: Divisions of aEmergency Medicine, Children’s Hospital Boston, Boston, MA 02115, USA. rebekah.mannix@childrens.harvard.edu
authors.forename: Rebekah
authors.initials: R
authors.lastname: Mannix
authors.forename: Eric
authors.initials: E
authors.lastname: Fleegler
authors.forename: William P
authors.initials: WP
authors.lastname: Meehan
authors.forename: Sara A
authors.initials: SA
authors.lastname: Schutzman
authors.forename: Kara
authors.initials: K
authors.lastname: Hennelly
authors.forename: Lise
authors.initials: L
authors.lastname: Nigrovic
authors.forename: Lois K
authors.initials: LK
authors.lastname: Lee
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence* / Q000401:mortality*; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D057207:Child Restraint Systems; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States