Premature graduation of children in child restraint systems: an observational study.

This study investigated the use and misuse of child restraint systems (CRS) in Flanders (Belgium). Observations were conducted at a random sample of primary school and recreation areas. In total 1376 children were observed. A logistic regression model was constructed in order to determine the variables involved. The parameter-estimates of this model have shown that children are more often restrained when the driver buckles up, the ride takes less than 1h, the children are younger, the children sit in the front seat of the car, a recreational area is the destination of the trip and there are less than five children in the car. Also premature graduation to CRS was analysed. More than half of the children are not appropriately restrained, according to their age, weight or height. Improper shoulder belt use (putting the shoulder belt behind the back or under the arm) was observed in 8.99% of the children being restrained with high back booster seats, in 32.73% of the children being restrained with backless booster seats and finally in 19.07% of the children being restrained with seat belts. The risk of incorrectly using the shoulder belt increases when children are prematurely graduated in a CRS. The results are discussed in the light of other studies on this matter.

[1]  Lawrence E Decina,et al.  Child restraint system use and misuse in six states. , 2005, Accident; analysis and prevention.

[2]  N C Kunkel,et al.  Do Parents Choose Appropriate Automotive Restraint Devices for Their Children? , 2001, Clinical pediatrics.

[3]  Thomas Turbell,et al.  Child safety in cars : Literature review , 2003 .

[4]  Donna Glassbrenner,et al.  Child Restraint Use in 2004--Overall Results , 2005 .

[5]  Steven Asch,et al.  Predictors of seat-belt use among school-aged children in two low-income Hispanic communities. , 2002, American journal of preventive medicine.

[6]  H M Corneli,et al.  Effect of Seating Position and Restraint Use on Injuries to Children in Motor Vehicle Crashes , 2000, Pediatrics.

[7]  Michael R. Elliott,et al.  Effects of Seating Position and Appropriate Restraint Use on the Risk of Injury to Children in Motor Vehicle Crashes , 2005, Pediatrics.

[8]  Narayan Yoganandan,et al.  Booster Seats for Children: Closing the Gap Between Science and Public Policy in the United States , 2003, Traffic injury prevention.

[9]  Frederick P Rivara,et al.  Too small for a seatbelt: predictors of booster seat use by child passengers. , 2003, Pediatrics.

[10]  K H Lococo,et al.  MISUSE OF CHILD RESTRAINTS , 2004 .

[11]  R. Medford.  National Highway Traffic Safety , 2005 .

[12]  Tony Chapman,et al.  Review of Best Practice , 2003 .

[13]  Kristy B Arbogast,et al.  Recent trends in child restraint practices in the United States. , 2004, Pediatrics.

[14]  D W Eby,et al.  Restraint use patterns for older child passengers in Michigan. , 2001, Accident; analysis and prevention.

[15]  F K Winston,et al.  Misuse of booster seats , 2000, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[16]  E. K. Moll,et al.  The danger of premature graduation to seat belts for young children. , 2000, Pediatrics.

[17]  F P Rivara,et al.  Booster Seat Use and Reasons for Nonuse , 2000, Pediatrics.

[18]  F Wegman,et al.  SUNFLOWER: A COMPARATIVE STUDY OF THE DEVELOPMENTS OF ROAD SAFETY IN SWEDEN, THE UNITED KINGDOM, AND THE NETHERLANDS , 2002 .

[19]  Donna Glassbrenner,et al.  Recent estimates of safety belt use. , 2004, Journal of safety research.

[20]  P F Agran,et al.  Factors associated with restraint use of children in fatal crashes. , 1998, Pediatrics.

[21]  D. Durbin,et al.  Belt-positioning booster seats and reduction in risk of injury among children in vehicle crashes. , 2003, JAMA.

[22]  K Weber,et al.  CRASH PROTECTION FOR CHILD PASSENGERS: A REVIEW OF BEST PRACTICE , 2000 .