title: Vehicle LATCH system features associated with correct child restraint installations.
abstract: OBJECTIVE
  Lower anchors and tethers for children (LATCH) was intended to standardize the attachment between child restraints and vehicle seats. However, LATCH implementations vary, resulting in differences in ease of attachment of child restraint connectors. Identifying vehicle characteristics associated with correct child restraint installations can provide guidance for designing vehicle LATCH systems that increase correct child restraint installations.
  
  
  METHODS
  The LATCH system and other relevant vehicle characteristics were documented in 98 top-selling 2010-2011 vehicles. These features, together with proposed LATCH usability recommendations from the International Organization for Standardization and Society of Automotive Engineers, were used to select 12 vehicles for volunteer testing with a range of LATCH system characteristics. Thirty-six volunteers were assigned to 4 groups; each group tested 3 vehicles, 4 child restraints (infant, rear-facing convertible, forward-facing convertible, and combination seat), and 2 installation methods (lower anchors and seat belt) in a split-plot experimental design. Mixed-effects logistic regression models were used to identify predictors of tight installation and correct lower anchor use.
  
  
  RESULTS
  Vehicle survey results indicated that most vehicle manufacturers provide the minimum number of LATCH hardware locations required by regulation. Among 21 vehicles with a third row, 4 had no tether anchors and 11 had no lower anchors in the third row. Study volunteers correctly used the lower anchors in 60 percent of LATCH installations and used the top tether in 48 percent of forward-facing installations. When the tether was used, use was correct in 46 percent of trials (22% of all forward-facing installations). Only 13 percent of all trials had completely correct child restraint installation (correct use of lower anchors or seat belt, correct tether anchor use, tight seat installation, and correct installation angle). Tight installation was 3.3 times as likely with correct lower anchor use compared to trials with incorrect use. Three lower anchor characteristics were associated with rates of correct lower anchor use above 50 percent: clearance angle around the lower anchors greater than 54°, attachment forces less than 178 N, and anchor depth within the seat bight of less than 2 cm. Vehicles meeting all 3 criteria were 19 times as likely to have lower anchors used correctly compared to vehicles meeting none of the criteria. No vehicle features predicted either use of tethers or correct use of tethers.
  
  
  CONCLUSIONS
  Vehicle LATCH systems that improve lower anchor accessibility could increase the rate of correct lower anchor use, but more research is needed to understand factors associated with tether use and correct use.
authors.affiliation: University of Michigan Transportation Research Institute, Ann Arbor, Michigan, USA. kklinich@umich.edu
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Klinich
authors.forename: Carol A C
authors.initials: CA
authors.lastname: Flannagan
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Jermakian
authors.forename: Anne T
authors.initials: AT
authors.lastname: McCartt
authors.forename: Miriam A
authors.initials: MA
authors.lastname: Manary
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Moore
authors.forename: Joann K
authors.initials: JK
authors.lastname: Wells
mesh_terms: D001336:Automobiles / Q000592:standards / Q000706:statistics & numerical data*; D002648:Child; D057207:Child Restraint Systems / Q000592:standards* / Q000706:statistics & numerical data*; D004867:Equipment Design; D006801:Humans; D007223:Infant