Car safety seats for children:​ rear facing for best protection

Henary, B.; Sherwood, C. P.; Crandall, J. R.; Kent, R. W.; Vaca, F. E.; Arbogast, K. B.; Bull, M. J.

Affiliations

¹Center for Applied Biomechanics, University of Virginia, Charlottesville, VA, USA

²Center for Trauma and Injury Prevention Research, University of California, Irvine, CA, USA

³Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

⁴Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

Abstract

Objective: To compare the injury risk between rear-facing (RFCS) and forward-facing (FFCS) car seats for children less than 2 years of age in the USA.

Methods: Data were extracted from a US National Highway Traffic Safety Administration vehicle crash database for the years 1988–2003. Children 0–23 months of age restrained in an RFCS or FFCS when riding in passenger cars, sport utility vehicles, or light trucks were included in the study. Logistic regression models and restraint effectiveness calculations were used to compare the risk of injury between children restrained in RFCSs and FFCSs.

Results: Children in FFCSs were significantly more likely to be seriously injured than children restrained in RFCSs in all crash types (OR = 1.76, 95% CI 1.40 to 2.20). When considering frontal crashes alone, children in FFCSs were more likely to be seriously injured (OR = 1.23), although this finding was not statistically significant (95% CI 0.95 to 1.59). In side crashes, however, children in FFCSs were much more likely to be injured (OR = 5.53, 95% CI 3.74 to 8.18). When 1 year olds were analyzed separately, these children were also more likely to be seriously injured when restrained in FFCSs (OR = 5.32, 95% CI 3.43 to 8.24). Effectiveness estimates for RFCSs (93%) were found to be 15% higher than those for FFCSs (78%).

Conclusions: RFCSs are more effective than FFCSs in protecting restrained children aged 0–23 months. The same findings apply when 1 year olds are analyzed separately. Use of an RFCS, in accordance with restraint recommendations for child size and weight, is an excellent choice for optimum protection up to a child’s second birthday.

Links

DOI: 10.1136/ip.2006.015115

PubMed: 18056317

WoS: 000251361800010

History

Accepted: 2007-08-28

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Cited By (11)

Year	Entry
2015	Klinich KD, Manary MA. Best practice recommendations for protecting child occupants. In: Yoganandan N, Nahum AM, Melvin JW, eds. Accidental Injury: Biomechanics and Prevention. 3rd ed. New York: Springer; 2015:697-719.
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