Shifts in child restraint use according to child weight in the United States from 1999 to 2002

Winston, Flaura K.; Chen, Irene G.; Arbogast, Kristy B.; Elliott, Michael R.; Durbin, Dennis R.

Affiliations

¹TraumaLink: The Interdisciplinary Pediatric Injury Control Research Center, The Children’s Hospital of Philadelphia, Philadelphia, PA

²Division, General Pediatrics, Department of Pediatrics

³Division, Pediatric Emergency Medicine, Department of Pediatrics

⁴Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA

Abstract

From 1999 to 2002, 32% fewer US children between 9 and 36.4 kg (20-80 lb) were restrained inappropriately in seat belts and the most prevalent form of restraint shifted from seat belts to child restraints with harnesses. There was a significant increase in the use of combination child restraint/booster seats with harnesses by children 9.1-18.1 kg (20-40 lb). Among children weighing 14.1-18.1 kg (31- 40 lb), the inappropriate use of seat belts and shield boosters decreased. Among children weighing 18.6-27.2 kg (41-60 lb), the use of belt-positioning booster seats increased while the inappropriate use of seat belts decreased. Of note, by the end of 2002, 27% of children weighing between 18.6 and 22.7 kg (41-50 lb) were restrained in child restraints with harnesses. These children were of weights typically above the manufacturer’s recommended limit. Despite progress, substantial inappropriate restraint still remains and continued investment in outreach efforts is necessary. The risk of injury for heavier children in child restraints with harnesses should be monitored.

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Cited By (8)

Year	Entry
2003	Kallan MJ, Durbin DR, Elliott MR, Menon RA, Winston FK. Differential risk of injury in child occupants by passenger car classification. In: 47th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 22-24, 2003; Lisbon, Portugal.329-341.
2006	Padmanaban J, Mortazavi L. Kid in the middle: a discussion of effectiveness of center rear-seat restraint systems. In: 50th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 16-18, 2006; Chicago, IL.221-236.
2007	Augenstein J, Perdeck E, Digges K, Bahouth G. Age appropriate restraints for the right front passenger. In: 51st Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 15-17, 2007; Melbourne, Australia.381-394.
2011	Forman JL, Segui-Gomez M, Ash JH, Lopez-Valdes FJ. Child posture and shoulder belt fit during extended night-time traveling: an in-transit observational study. In: 55th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 3-5, 2011; Paris, France.3-14.
2005	Menon RA, Ghati YS, Roberts D. Performance evaluation of various high back booster seats tested at 56 kph using a 6-year-old Hybrid III dummy. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2005	Charlton JL, Fildes B, Laemmle R, Koppel S, Fechner L, Moore K, Smith S, Douglas F, Doktor I. Crash performance evaluation of booster seats for an Australian car. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2007	Menon R, Ghati Y, Jain P. MADYMO simulation study to optimize the seating angles and belt positioning of high back booster seats. In: Proceedings of the 20th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 18-21, 2007; Lyon, France.
2009	Augenstein J, Perdeck E, Digges K, Bahouth G. Opportunities for protecting the right front passenger in frontal crashes. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.