Effect of seating position and restraint use on injuries to children in motor vehicle crashes

Berg, Marc D.<sup>1</sup>; Cook, Lawrence<sup>2</sup>; Corneli, Howard M.<sup>3</sup>; Vernon, Donald D.<sup>1,2</sup>; Dean, J. Michael<sup>1,2</sup>

Affiliations

¹Divisions of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah

²Intermountain Injury Control Research Center, University of Utah, Salt Lake City, Utah

³Emergency Medicine, Department of Pediatrics, University of Utah, Salt Lake City, Utah

Abstract and keywords

Objective: To determine the effect of restraint use and seating position on injuries to children in motor vehicle crashes, with stratification by area of impact.

Methods: Children <15 years old involved in serious automobile crashes in Utah from 1992 through 1996 were identified from statewide motor vehicle crash records. Serious crashes are defined as those resulting in occupant injuries with broken bones or significant bleeding or property damage exceeding $750. Probabilistic methods were used to link these records with hospital records. Analysis used logistic regression controlling for age, restraint use, occupant seating position, and type of crash.

Results: We studied 5751 children and found 53% were rear seat passengers. More than 40% were unrestrained. Sitting in the rear seat offered a significant protective effect (adjusted odds ratio: 1.7; 95% confidence interval: 1.6–2.0), and restraint use enhanced this effect (adjusted odds ratio: 2.7; 95% confidence interval: 2.4–3.1). Mean hospital charges were significantly greater for front seat passengers.

Conclusions: Rear seat position during a motor vehicle crash provides a significant protective effect, restraint use furthers this effect, and usage rates of restraint devices are low. The rear seat protective effect is in addition to and independent of the protection offered from restraints.

Keywords: seat belt usage; motor vehicle crashes; rear seat; restraints; injury; children

Links

DOI: 10.1542/peds.105.4.831

PubMed: 10742328

WoS: 000086189400032

History

Received: 1999-06-25

Accepted: 1999-12-10

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Cited By (15)

Year	Entry
2000	Weber K. Crash protection for child passengers: a review of best practice. UMTRI Res Rev. July–September 2000;31(3):1-27.
2001	Durbin DR, Elliott M, Arbogast KB, Anderko RL, Winston FK. The effect of seating position on risk of injury for children in side impact collisions. In: 45th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 24-26, 2001; San Antonio, TX.
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.
2010	Sahraei E, Digges K, Marzougui D. Reduced protection for belted occupants in rear seats relative to front seats of new model year vehicles. In: 54th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 17-20, 2010; Las Vegas, NV.149-158.
2005	Maltese MR, Chen IG, Arbogast KB. The effect of rear row seating position on the risk of injury to belted children in side impacts in passenger cars. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2023	Bangert LG, Collins CJ, Riexinger LE. Do females have a higher risk of suffering distal tibia fractures in frontal car crashes? In: Proceedings of the 2023 International IRCOBI Conference on the Biomechanics of Injury. September 13-165, 2023; Cambridge, United Kingdom.244-253.
2008	Michaelson J, Forman J, Kent R, Kuppa S. Rear seat occupant safety: kinematics and injury of PMHS restrained by a standard 3-point belt in frontal crashes. Stapp Car Crash J. 2008;52:295-325. SAE 2008-22-0012.
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2005	Durbin DR, Chen I, Smith R, Elliott MR, Winston FK. Effects of seating position and appropriate restraint use on the risk of injury to children in motor vehicle crashes. Pediatrics. March 2005;115(3):e305-e309.
2014	Icke KJ. Determination of the Compressive Response of the Pediatric Thorax Utilizing System Identification Techniques [PhD thesis]. The Ohio State University; 2014.
2002	Giacomin JA. An Experimental Investigation of the Vibrational Comfort of Child Safety Seats [PhD thesis]. University of Sheffield; December 2002.
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