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Car seat inspection among children older than 3 years: Using data to drive practice in child passenger safety
Amber M Kroeker1, Amy J Teddy, Michelle L Macy
1From the Pediatric Trauma Program (A.M.K.), Department of Surgery, and Child Health Evaluation and Research (CHEAR) Unit (A.J.T., M.L.M.), Division of General Pediatrics, and Department of Emergency Medicine (M.L.M.), University of Michigan, Ann Arbor, Michigan.
Insights
Child passenger safety programs often overlook booster-aged children. Inspections show many older children use suboptimal restraints, highlighting a need for improved safety focus on booster seats for children aged 4 and older.
Area of Science:
- Pediatric injury prevention
- Public health interventions
- Traffic safety research
Background:
- Motor vehicle crashes are a leading cause of unintentional death and disability for US children aged 4-12.
- Existing child passenger safety programs may not adequately address this age group's specific risks.
- Parental awareness regarding appropriate restraint use for older children needs enhancement.
Purpose of the Study:
- To analyze restraint types used by children attending car seat inspections.
- To identify potential gaps in child passenger safety programs for booster-aged children.
- To evaluate the effectiveness of car seat inspections in improving restraint use.
Main Methods:
- Retrospective cross-sectional analysis of child passenger safety seat checklist forms from Michigan Safe Kids coalitions (2013).
- Data included restraint type upon arrival, provision of new seats, and sibling attendance.
- Chi-squared statistics were used to analyze restraint use changes and demographic distributions.
Main Results:
- Booster seats were used by only 10.8% of inspected children; infant/toddler seats were more common.
- 5.4% used only a seat belt, and 13.8% had no restraint.
- Children aged 4 and older were in suboptimal restraints over 30% of the time.
Conclusions:
- Car seat inspections are underutilized for children in the booster seat age range.
- Inspection events successfully increased the proportion of children in more protective restraints, especially with increasing age.
- There is a critical need to strengthen child passenger safety efforts for booster-aged children.
Background:
Motor vehicle crashes are the leading cause of unintentional death and disability among children 4 years to 12 years of age in the United States. Despite the high risk of injury from motor vehicle crashes in this age group, parental awareness and child passenger safety programs in particular may lack focus on this age group.
Methods:
This is a retrospective cross-sectional analysis of child passenger safety seat checklist forms from two Safe Kids coalitions in Michigan (2013) to identify restraint type upon arrival to car seat inspections. Other variables were included if the coalition provided a new child safety seat and if the child had a sibling who underwent a car seat inspection. χ statistics were used to compare change in restraint use on arrival and at departure, the proportion of children attending a car seat inspection event by age, the age category of children by site, the proportion of children with siblings also undergoing a car seat inspection by age, and the distribution of a new child safety seat by age.
Results:
Data were available from 1,316 Safe Kids Huron Valley and 3,215 Safe Kids Greater Grand Rapids car seat inspections. Just 10.8% of the total seats inspected were booster seats. Child safety seats for infant and young children were more commonly inspected (rear-facing carrier [40.3%], rear-facing convertible [10.2%], and forward-facing [19.3%] car seats). Few children at inspections used a seat belt only (5.4%) or had no restraint (13.8%). Children 4 years and older were found to be in a suboptimal restraint at least 30% of the time.
Conclusion:
Low proportions of parents use car seat inspections for children in the booster seat age group. The proportion of children departing the inspection in a more protective restraint increased with increasing age. This highlights an area of weakness in child passenger safety programs and signals an opportunity to strengthen efforts on The Booster Age Child.
Level Of Evidence:
Epidemiologic/prognostic study, level III.
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