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Cai W, Lei L, Zhou H, Wang Y, Peng J, Jin Y, Deng X. Child restraint system use and its associated factors in Shenzhen. ACCIDENT; ANALYSIS AND PREVENTION 2021; 160:106321. [PMID: 34339910 DOI: 10.1016/j.aap.2021.106321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/15/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
Child restraint system (CRS) is effective to protect child passenger safety in a motor vehicle crash. However, research on CRS is limited and the use rate of CRS is not high in China. We carried out a cross-sectional study to examine the use of CRS and its associated factors in Shenzhen. Via the method of cluster random sampling, parents who had at least one child aged 0 to 6 and owned a car from nine community health service centers and eight kindergartens were invited to complete the self-administered questionnaire during April and May 2014, including their knowledge of, attitude toward, and use behavior of CRS and socio-demographics. Multivariable logistic regression was used to explore the factors associated with CRS use. A total of 3768 parents participated in the survey, with a mean age of 33.94. Parents' knowledge and attitude regarding CRS were fair, with the mean score of 3.07 and 3.33 out of 6, respectively, and only 22.8% of them used CRS for their child passengers. Children aged below 3 years, drivers owing expensive cars and wearing seatbelts, and parents with higher knowledge and attitude scores had greater likelihoods to use CRS. Moreover, trip frequency and distance were also significantly associated with CRS use. The findings indicate that the use rate of CRS is low in Shenzhen and parents have fair levels of knowledge and attitude regarding CRS use. Comprehensive public education programs and legislative interventions are urgently required to increase the use of CRS and ensure child passenger safety in Shenzhen.
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Affiliation(s)
- Weicong Cai
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; The George Institute for Global Health, University of New South Wales, NSW 2042, Australia.
| | - Lin Lei
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Haibin Zhou
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Yirong Wang
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Ji Peng
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Ye Jin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Xiao Deng
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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Smiley ML, Bingham CR, Jacobson PD, Macy ML. Discordance between age- and size-based criteria of child passenger restraint appropriateness. TRAFFIC INJURY PREVENTION 2018; 19:326-331. [PMID: 29148838 PMCID: PMC6309830 DOI: 10.1080/15389588.2017.1403016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 11/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015. METHODS Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n = 591 in 2011, n = 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S. GUIDELINES Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics. RESULTS Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%, P < .001), lower weight (57 vs. 47%, P = .005), higher weight (25 vs. 19%, P = .03), greater height (39 vs. 26%, P < .001), and greater size (42 vs. 30%, P = .001). CONCLUSIONS The percentage of children considered to be using an appropriate restraint varied substantially across criteria. Aligning the definition of appropriate restraint use with current U.S. guidelines would increase consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with higher weight and height limits.
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Affiliation(s)
- Mary L Smiley
- a South Carolina Department of Health and Environmental Control , Columbia , South Carolina
| | - C Raymond Bingham
- b Young Driver Behavior and Injury Prevention Group , University of Michigan Transportation Research Institute , Ann Arbor , Michigan
- c Department of Health Behavior and Health Education , University of Michigan School of Public Health , Ann Arbor , Michigan
| | - Peter D Jacobson
- d Center for Law, Ethics, and Health , University of Michigan School of Public Health , Ann Arbor , Michigan
| | - Michelle L Macy
- e Department of Emergency Medicine and the Child Health Evaluation and Research (CHEAR) Unit , Division of General Pediatrics, University of Michigan Medical School , Ann Arbor , Michigan
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Lee YY, Fang E, Weng Y, Ganapathy S. Road traffic accidents in children: the 'what', 'how' and 'why'. Singapore Med J 2017; 59:210-216. [PMID: 29214322 DOI: 10.11622/smedj.2017114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Road traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents. METHODS This was a retrospective study of RTAs involving children aged 0-16 years who presented to the Children's Emergency at KK Women's and Children's Hospital, Singapore, from January 2011 to June 2014. Data was obtained from the National Trauma Registry and analysed in tiers based on the Injury Severity Score (ISS). RESULTS A total of 1,243 accidents were reviewed. RTA victims included motor vehicle passengers (60.4%), pedestrians (28.5%), cyclists (9.9%) and motorcycle pillion riders (1.2%). The disposition of emergency department (ED) patients was consistent with RTA severity. For serious RTAs, pedestrians accounted for 63.6% and 57.7% of Tier 1 (ISS > 15) and Tier 2 (ISS 9-15) presentations, respectively. Overall use of restraints was worryingly low (36.7%). Not restraining increased the risk of serious RTAs by 8.4 times. Young age, high ISS and low Glasgow Coma Scale score predicted a longer duration of intensive care unit stay. CONCLUSION The importance of restraints for motor vehicle passengers or helmets for motorcycle pillion riders and cyclists in reducing morbidity requires emphasis. Suggestions for future prevention and intervention include road safety education, regulation of protective restraints, use of speed enforcement devices and creation of transport policies that minimise kerbside parking.
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Affiliation(s)
- Yue Yen Lee
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Eric Fang
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Yanyi Weng
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
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Benedetti M, Klinich KD, Manary MA, Flannagan CA. Predictors of restraint use among child occupants. TRAFFIC INJURY PREVENTION 2017; 18:866-869. [PMID: 28429962 DOI: 10.1080/15389588.2017.1318209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 04/07/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The objective of this study was to identify factors that predict restraint use and optimal restraint use among children aged 0 to 13 years. METHODS The data set is a national sample of police-reported crashes for years 2010-2014 in which type of child restraint is recorded. The data set was supplemented with demographic census data linked by driver ZIP code, as well as a score for the state child restraint law during the year of the crash relative to best practice recommendations for protecting child occupants. Analysis used linear regression techniques. RESULTS The main predictor of unrestrained child occupants was the presence of an unrestrained driver. Among restrained children, children had 1.66 (95% confidence interval, 1.27, 2.17) times higher odds of using the recommended type of restraint system if the state law at the time of the crash included requirements based on best practice recommendations. CONCLUSIONS Children are more likely to ride in the recommended type of child restraint when their state's child restraint law includes wording that follows best practice recommendations for child occupant protection. However, state child restraint law requirements do not influence when caregivers fail to use an occupant restraint for their child passengers.
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Affiliation(s)
- Marco Benedetti
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Kathleen D Klinich
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Miriam A Manary
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Carol A Flannagan
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
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Klinich KD, Benedetti M, Manary MA, Flannagan CA. Rating child passenger safety laws relative to best practice recommendations for occupant protection. TRAFFIC INJURY PREVENTION 2017; 18:406-411. [PMID: 27574894 DOI: 10.1080/15389588.2016.1203427] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 06/15/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND State laws regarding child passenger protection vary substantially. OBJECTIVES The objective of this study was to develop a scoring system to rate child passenger safety laws relative to best practice recommendations for each age of child. METHODS State child passenger safety and seat belt laws were retrieved from the LexisNexis database for the years 2002-2015. Text of the laws was reviewed and compared to current best practice recommendations for child occupant protection for each age of child. RESULTS A 0-4 scale was developed to rate the strength of the state law relative to current best practice recommendations. A rating of 3 corresponds to a law that requires a restraint that is sufficient to meet best practice, and a rating of 4 is given to a law that specifies several options that would meet best practice. Scores of 0, 1, or 2 are given to laws requiring less than best practice to different degrees. The same scale is used for each age of child despite different restraint recommendations for each age. Legislation that receives a score of 3 requires rear-facing child restraints for children under age 2, forward-facing harnessed child restraints for children aged 2 to 4, booster seats for children 5 to 10, and primary enforcement of seat belt use in all positions for children aged 11-13. Legislation requiring use of a "child restraint system according to instructions" would receive a score of 1 for children under age 2 and a 2 for children aged 2-4 because it would allow premature use of a booster for children weighing more than 13.6 kg (30 lb). CONCLUSIONS The scoring system developed in this study can be used in mathematical models to predict how child passenger safety legislation affects child restraint practices.
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Affiliation(s)
- Kathleen D Klinich
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Marco Benedetti
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Miriam A Manary
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
| | - Carol A Flannagan
- a University of Michigan Transportation Research Institute , Ann Arbor , Michigan
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Seven great achievements in pediatric research in the past 40 y. Pediatr Res 2016; 80:330-7. [PMID: 27556199 DOI: 10.1038/pr.2016.95] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 02/26/2016] [Indexed: 02/05/2023]
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Soori H, Ainy E, Bazargan-Hejazi S. Opportunities, threats and barriers to enacting mandatory child car restraint laws in Iran. Int J Inj Contr Saf Promot 2014; 22:314-9. [PMID: 25105992 DOI: 10.1080/17457300.2014.908227] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Approximately one-third of Iranian children's deaths are caused by injuries. Of these, 36% result from road traffic injuries (RTIs). Both RTIs and fatalities could be reduced by using child car restraints (CCRs). Despite their demonstrated effectiveness, CCRs are not mandatory in Iran. This study was conducted to assess opportunities and barriers in enacting mandatory CCR laws in that country. Using mixed method research, a phenomenological approach was used to explore the experiences and perspectives of road safety stakeholders in regard to opportunities and threats in enacting mandatory CCR laws in Iran. The themes derived from group discussions were used to first develop a structured questionnaire, which was later distributed to and completed by study participants. The study analysis was conducted using scores and rankings from the responses to these questions. Twenty-eight stakeholders participated in the study. Most were male, aged 36.7 ± 5.6 (range 25-59). In terms of identifying the organization that should establish mandatory CCR laws, the Traffic Police Department achieved the highest score of 90 (range 0-100). The participants also thought that the Traffic Police department is responsible to monitor compliance and conduct follow-up investigations (score = 100). In regard to existing barriers in enacting CCR laws, the lack of positive Publicity by mass media and the lack of related laws received scores of 85 and 70, respectively. Enabling factors and opportunities included 'positive regards or attitude of families towards their child's health,' 'officials' commitment to support such laws' and 'having adequate resources to raise community awareness of the importance of CCR use. These received scores of 83, 69 and 68, respectively. The results suggest that cooperation and collaboration among stakeholders including the Traffic Police, families and local communities are needed to maximize the likelihood of mandating CCR laws.
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Affiliation(s)
- Hamid Soori
- a Safety Promotion and Injury Prevention Research Center, School of Public Health , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - Elaheh Ainy
- b Safety Promotion and Injury Prevention Research Center , Shahid Beheshti University of Medical Science , Tehran , Iran
| | - Shahrzad Bazargan-Hejazi
- c Department of Psychiatry , Charles R. Drew University of Medicine and Science of California , Los Angeles , CA , USA
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Falk H, Briss P. Environmental- and injury-related epidemic-assistance investigations, 1946-2005. Am J Epidemiol 2011; 174:S65-79. [PMID: 22135395 DOI: 10.1093/aje/kwr313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This paper summarizes environmental investigations (n = 458) conducted during the first 60 years of the epidemic-assistance investigation program at the Centers for Disease Control and Prevention. These investigations were grouped into 10 categories: toxic chemicals (n = 102), indoor air quality and outdoor air toxics (n = 21), new or rare epidemic diseases and unexplained syndromes (n = 29), natural disasters (n = 81), terrorism and unintentional human-made disasters (n = 9), substance use and abuse (n = 13), environmental aspects of infectious disease (n = 132), those affecting neonates and infants (n = 11), violence and injuries (n = 51), and miscellaneous (n = 9). Among the most important or prominent were studies of lead and arsenic toxicity at smelters, mercury in paint and beauty creams, dioxin in waste oil in Missouri, polychlorinated biphenyls and multiple other toxic chemicals, global pesticide poisoning outbreaks, hepatic angiosarcoma among vinyl chloride workers, toxic oil syndrome in Spain, eosinophilia-myalgia syndrome from contaminated L-tryptophan, diethylene glycol poisoning in Haiti, aflatoxicosis in Kenya, Gulf War illness among veterans, impact and needs assessments during natural disasters (e.g., Hurricane Katrina (2005) and the Mount St. Helens volcano eruptions (1980)), risk factors for heat-related mortality, domestic and international terrorist attacks, Parkinsonism related to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine in California, and unintentional injury- and violence-related events.
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Affiliation(s)
- Henry Falk
- Office of Deputy Director for Non-Communicable Diseases, Injury, and Environmental Health, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS F-64, Atlanta, GA 30333, USA.
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The increase in the user rate of child seats is clearly an important factor in the decreases in the rates of death and serious injury. Am J Forensic Med Pathol 2011; 33:e1. [PMID: 22083075 DOI: 10.1097/paf.0b013e31823a8b08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cunningham CE, Bruce BS, Snowdon AW, Chen Y, Kolga C, Piotrowski C, Warda L, Correale H, Clark E, Barwick M. Modeling improvements in booster seat use: a discrete choice conjoint experiment. ACCIDENT; ANALYSIS AND PREVENTION 2011; 43:1999-2009. [PMID: 21819828 DOI: 10.1016/j.aap.2011.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 03/30/2011] [Accepted: 05/17/2011] [Indexed: 05/31/2023]
Abstract
Automobile crashes are the leading cause of death in children aged 1-14 years. Many children, however, are not properly restrained in safety seats that reduce serious injury and death. This study used a discrete choice conjoint experiment to study factors influencing the decision to use booster seats. Parents of 1714 children aged 4-9 years from nine Canadian provinces completed choice tasks presenting experimentally varied combinations of 15 4-level booster seat promotion attributes. Latent class analysis yielded three segments of parents. The choices of the Benefit Sensitive segment (50%) were most sensitive to the injury prevention benefits of booster seats. The choices of parents in the Context Sensitive segment (33.5%) were more likely to be influenced by installation complexity, oppositional behavior, and the prospect that their child may be teased for riding in booster seats. Parents in the High Risk segment (16.5%) were younger, less educated, and less knowledgeable about vehicle safety legislation. They anticipated fewer benefits, expected more barriers and were less likely to use booster seats. Simulations suggest that consistent enforcement coupled with advertising focusing on injury prevention and the use of booster seats by other parents would increase adoption.
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Affiliation(s)
- Charles E Cunningham
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L9C 7N4, Canada.
| | - Beth S Bruce
- Faculty of Health Professions, Dalhousie University, Halifax, Canada
| | - Anne W Snowdon
- Odette School of Business, University of Windsor, Windsor, Canada
| | - Yvonne Chen
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario L9C 7N4, Canada
| | | | - Caroline Piotrowski
- Department of Family Social Sciences, University of Manitoba, Winnipeg, Canada
| | - Lynne Warda
- Department of Pediatrics, University of Manitoba, Winnipeg, Canada
| | - Heather Correale
- School of Nursing, University of Northern British Columbia, British Columbia, Canada
| | - Erica Clark
- School of Nursing, University of Northern British Columbia, British Columbia, Canada
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Purc-Stephenson RJ, Ren J, Snowdon AW. An exploratory study of parents' use and knowledge of car safety seats in Beijing, China. Int J Inj Contr Saf Promot 2011; 17:231-8. [PMID: 20521194 DOI: 10.1080/17457300.2010.487155] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
As the number of vehicles in China rapidly increases and there is no child safety seat law, the issue of road safety for children is a growing concern. The purpose of this study was to examine parents' use and knowledge of car safety seats in Beijing, China. Using a convenience sample of 843 parents, survey results showed that only 64.8% of parents used a safety restraint for their children; the remaining 35.2% of children, of which most were toddlers or school-aged children, travelled unrestrained in vehicles. Among parents who used a safety restraint, only 24.2% were using it correctly based on the child's age (for infants), weight and height. Common reasons for not using a safety seat included difficulty finding safety seats (56.6%), cost (26.1%), and a preference to hold the child (18.1%). Moreover, a large proportion of parents prematurely transitioned their child from a safety seat to seat belt. The results highlight the need to develop injury prevention interventions that communicate the benefits and encourage the use of child safety restraints in China.
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Abstract
Despite significant reductions in the number of children killed in motor vehicle crashes over the past decade, crashes continue to be the leading cause of death for children 4 years and older. Therefore, the American Academy of Pediatrics continues to recommend inclusion of child passenger safety anticipatory guidance at every health-supervision visit. This technical report provides a summary of the evidence in support of 5 recommendations for best practices to optimize safety in passenger vehicles for children from birth through adolescence that all pediatricians should know and promote in their routine practice. These recommendations are presented in the revised policy statement on child passenger safety in the form of an algorithm that is intended to facilitate their implementation by pediatricians with their patients and families. The algorithm is designed to cover the majority of situations that pediatricians will encounter in practice. In addition, a summary of evidence on a number of additional issues that affect the safety of children in motor vehicles, including the proper use and installation of child restraints, exposure to air bags, travel in pickup trucks, children left in or around vehicles, and the importance of restraint laws, is provided. Finally, this technical report provides pediatricians with a number of resources for additional information to use when providing anticipatory guidance to families.
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Kulanthayan S, Razak A, Schenk E. Driver characteristics associated with child safety seat usage in Malaysia: a cross-sectional study. ACCIDENT; ANALYSIS AND PREVENTION 2010; 42:509-514. [PMID: 20159074 DOI: 10.1016/j.aap.2009.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 09/11/2009] [Accepted: 09/18/2009] [Indexed: 05/28/2023]
Abstract
BACKGROUND The rapidly motorizing environment in Malaysia has made child occupant safety a current public health concern. The usage of child safety seats (CSS) is a widely regarded intervention to enhance child occupant safety, yet no study has been conducted on CSS in Malaysia. This study aims to determine the CSS usage rates in Malaysia and to assess driver characteristics that are associated with CSS usage. METHODS Nine variables - urban versus rural study location, age, gender, marital status, educational status, monthly family income, number of children present in the vehicle, distance traveled to the study location, and attitude - were examined through a cross-sectional study of interviewing drivers of 230 vehicles transporting at least one child <10 years of age at the time of the study. The vehicles were also observed for whether or not there was a CSS present. The interviews were conducted at six sampling locations - three urban and three rural - in the state of Melaka. RESULTS 27.4% of the drivers were found to be using at least one CSS at the time of the survey. Among the nine variables studied, three of the driver characteristics showed statistical significance (p<0.05) with CSS usage: age (p=0.047), educational status (p=0.009), and attitude (p=0.009). DISCUSSION This study begins to create knowledge on child occupant safety in Malaysia. The results indicate that interventional efforts should focus on educational programs geared toward drivers that are less educated or extended family members who inconsistently transport young children. Furthermore, any educational efforts could be strongly enhanced by legislation mandating the use of CSS. Every effort should be made to thoroughly assess the effectiveness of any educational or legislative activities that are implemented.
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Affiliation(s)
- S Kulanthayan
- Road Safety Research Centre, Faculty of Engineering, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
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Brixey S, Ravindran K, Guse CE. Legislating child restraint usage -Its effect on self-reported child restraint use rates in a central city. JOURNAL OF SAFETY RESEARCH 2010; 41:47-52. [PMID: 20226950 DOI: 10.1016/j.jsr.2009.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 11/18/2009] [Accepted: 12/15/2009] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess the effect of the newly enacted child passenger safety law, Wisconsin Act 106, on self-report of proper restraint usage of children in Milwaukee's central city population. METHOD A prospective, non-randomized study design was used. The settings used were (a) a pediatric urban health center, and (b) two Women, Infants and Children offices in Milwaukee, Wisconsin. Participants included 11,566 surveys collected over 18 months that spanned the pre-legislation and post-legislation time periods from February 2006 through August 2008. RESULTS The study set out to assess appropriate child passenger restraint. The results showed that the changes in adjusted proper restraint usage rates for infants between the pre-law, grace period, and post-fine periods were 94%, 94%, and 94% respectively. For children 1-3years old, the adjusted proper usage rates were 65%, 63%, and 59%, respectively. And for children 4-7years old, the rates were 43%, 44% and 42%, respectively. There was a significant increase in premature booster seat use in children who should have been restrained in a rear- or forward-facing car seat (10% pre-law, 12% grace period, 20% post-fine; p<0.0005). There was no statistically significant change over time in unrestrained children (2.1%, 1.7%, 1.7%, p=0.7, respectively). CONCLUSIONS The passage of a strengthened child passenger safety law with fines did not significantly improve appropriate restraint use for 0-7year olds, and appropriate use in 1-7year olds remained suboptimal with a majority of urban children inappropriately restrained. Although the number of unrestrained children decreased, we identified an unintended consequence of the legislation - a significant increase in the rate of premature belt-positioning booster seat use among poor, urban children. IMPACT ON INDUSTRY The design of child restraint systems maximizes protection of the child. Increasing reports of misuse is a call to those who manufacture these child passenger restraints to improve advertising and marketing to the correct age group, ease of installation, and mechanisms to prevent incorrect safety strap and harness placement. To ensure accurate and consistent use on every trip, car seat manufacturers must ensure that best practice recommendations for use as well as age, weight, and height be clearly specified on each child restraint. The authors support the United States Department of Transportation's new consumer program that will assist caregivers in identifying the child seat that will fit in their vehicle. In addition, due to the increase in premature graduation of children into belt-positioning booster seats noted as a result of legislation, promoting and marketing booster seat use for children less than 40 pounds should not be accepted. Child passenger safety technicians must continue to promote best practice recommendations for child passenger restraint use and encourage other community leaders to do the same.
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Affiliation(s)
- Suzanne Brixey
- Department of Pediatrics and Injury Research Center, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.
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Motor Vehicle Occupant Injury and Related Hospital Expenditures in Children Aged 3 Years to 8 Years Covered Versus Uncovered by Booster Seat Legislation. ACTA ACUST UNITED AC 2009; 67:S20-9. [DOI: 10.1097/ta.0b013e3181951a90] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Snowdon AW, Hussein A, Purc-Stevenson R, Follo G, Ahmed E. A longitudinal study of the effectiveness of a multi-media intervention on parents' knowledge and use of vehicle safety systems for children. ACCIDENT; ANALYSIS AND PREVENTION 2009; 41:498-505. [PMID: 19393799 DOI: 10.1016/j.aap.2009.01.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Revised: 12/31/2008] [Accepted: 01/27/2009] [Indexed: 05/27/2023]
Abstract
Motor-vehicle crashes are the leading cause of death and serious injury for children under the age of 14 in Canada and in the United States despite mandatory use of vehicle restraints since 1977. Using a pre- and post-test design, the present study tests the effectiveness of a multi-media intervention study on parents' knowledge of car safety seat use for children (0-12 years). The sample included 201 parents from four Ontario cities. Results indicate that parents' knowledge of when to accurately and safely transition a child to the appropriate car safety seat based on child's age, weight and height was retained at the 1 year post-test for children 4-8 years of age. The rates of correct use of safety seats significantly increased 1 year following the intervention program. Other factors that influenced parent's knowledge included being a parent versus non-parents, gender, income, education, sources of information, and regional location. The results of this study can help guide the development and implementation of future intervention programs and injury prevention policy.
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Snowdon AW, Hussein AA, Ahmed SE. Children at risk: predictors of car safety seat misuse in Ontario. ACCIDENT; ANALYSIS AND PREVENTION 2008; 40:1418-1423. [PMID: 18606275 DOI: 10.1016/j.aap.2008.03.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 12/29/2007] [Accepted: 03/12/2008] [Indexed: 05/26/2023]
Abstract
When used correctly, child safety seats can reduce the risk of death and serious injury by 54% in toddlers and 71% in infants [National Highway Traffic Safety Administration (NHTSA), 2001. Traffic Safety Facts 2001. Children (DOT HS 809 471), U.S. Department of Transportation, Washington, DC]. The purpose of this study was to identify factors that predict correct use of car safety seats. The study was conducted in a large urban area in Southwestern Ontario and a small urban and rural area in Northern Ontario. Participants were 1263 caregivers who completed a self-report survey on their knowledge and use of car safety seats for their children (N=2199). Logistic regression analysis revealed that female caregivers, caregivers with higher levels of education, and caregivers who reported that finding information about the correct use of child safety seats was "difficult" were more likely to report correctly using car safety seats. The results also showed that children aged 7 months to 8 years old had substantially lower odds of being in the correct car safety seat compared to children aged 6 months or younger, or children aged 9 years or older. The high risk nature of misuse of child seats for infants and younger children may be an important cue to action for health professionals to develop comprehensive prevention strategies.
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Affiliation(s)
- Anne W Snowdon
- Odette School of Business, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, Canada.
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Abstract
AIM The aim of this study was to understand the need for, and use of, booster seats in the 4-12 years age group and to identify risk factors for booster seat-non-use. METHOD A cross-sectional sample of 1101 children aged 4-12 years travelling in 663 privately owned vehicles was taken from the Auckland region. Auckland is New Zealand's largest population centre, with a population of over 1.5 million. Information was gathered using a short questionnaire followed by direct inspection to identify those children using booster seats. The SafetyBeltSafe USA '5-step rule' was used to look at those children not using a booster seat to determine whether one was still required. RESULTS While booster seat use has improved significantly in younger children since a similar study in 1992, only 40% of sampled children requiring a booster seat were using one. Booster seat use by children requiring them declined sharply as age increased. While 93% of 5- to 8-year-olds required a booster, only 30% were using one. The requirement for booster seats fell dramatically to 34% of 9- to 12-year-olds, but only 3% were using one. CONCLUSION The high rate of need for booster seats and the lack of use of booster seats in children aged 5-8 years is a strong argument for legislation and education programmes targeting this age group. While the proportion of 9- to 12-year-olds needing a booster drops sharply, there would likely be benefits from educating parents on the '5-step rule' or similar method to help identify the 30% of these older children that would continue to benefit from a booster seat. Rear seating should be promoted alongside booster seat use in the age group 4-12 years.
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Affiliation(s)
- Leanne Cameron
- Emergency Department, Starship Hospital, Auckland, New Zealand.
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