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Rear-facing versus forward-facing child restraints: an updated assessment

Timothy L McMurry1, Kristy B Arbogast2, Christopher P Sherwood3

  • 1Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA.

Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention
|November 28, 2017
PubMed

Insights

Child safety seats in rear-facing child restraint systems (RFCRS) are recommended for young children. While US data is limited, non-US evidence supports keeping children in RFCRS longer to reduce injuries.

Area of Science:

  • Pediatric safety
  • Transportation safety
  • Biomechanical engineering

Background:

  • Current recommendations for rear-facing child restraint systems (RFCRS) are based on lab tests and non-US data.
  • Concerns about the strength of US field evidence prompted a re-evaluation.

Purpose of the Study:

  • To re-evaluate US field evidence supporting RFCRS recommendations using the NASS-CDS database.
  • To analyze injury rates for infants in RFCRS versus forward-facing child restraint systems (FFCRS).

Main Methods:

  • Utilized the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) database (1988-2015).
  • Compared injury rates for children aged 0-23 months in RFCRS and FFCRS using weighted chi-squared tests.

Main Results:

  • Analysis included 1107 children; 47 sustained significant injuries (ISS ≥ 9).
  • Both 0- and 1-year-olds in RFCRS showed lower injury rates than those in FFCRS.
  • Sample size was insufficient for robust statistical power or covariate-controlled regression.

Conclusions:

  • Non-US field data and lab tests support extended RFCRS use.
  • US NASS-CDS data, while indicating lower injury rates in RFCRS, is too limited to strongly support current recommendations.
Abstract

Keywords:
behaviorchildchild survivalepidemiologymotor vehicle occupant

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