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Child restraint use in motor vehicles in Shanghai, China: a multiround cross-sectional observational study
Ting Chen1, Abdul M Bachani2, Qingfeng Li3
1Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Insights
Child safety restraint use in Shanghai is low, with only 6.42% of children observed using them. Factors like younger age and rear seat placement increase use, highlighting needs for targeted interventions to improve child passenger safety.
Area of Science:
- Public Health
- Pediatrics
- Transportation Safety
Background:
- Child restraint systems significantly reduce injury and fatality risks in motor vehicles.
- Child restraint practice in China remains understudied, necessitating local data for effective interventions.
Purpose of the Study:
- To determine the prevalence of child restraint system (CRS) use in Shanghai, China.
- To identify risk factors associated with CRS use among child occupants.
Main Methods:
- A cross-sectional observational study involving 12,061 child occupants in Shanghai.
- Data collection occurred across eight rounds from October 2015 to April 2019 near key child-frequented locations.
- Trained field workers recorded CRS usage in observed vehicles.
Main Results:
- The overall child safety restraint use rate was low at 6.42%, though it increased over the study period.
- Higher likelihood of CRS use was associated with younger children (under 5 years), rear seat placement, and observation near entertainment venues or shopping malls.
- Morning travel and proximity to children's hospitals were also factors influencing CRS use.
Conclusions:
- Child restraint use in Shanghai is alarmingly low, indicating a critical need for improved safety measures.
- Findings provide crucial insights for developing targeted intervention programs to enhance CRS adoption.
- Promoting CRS use is vital for preventing child road traffic injuries and fatalities in the region.
Objectives:
While appropriate child restraint use in motor vehicles can reduce the risk of injuries or deaths, few previous studies have assessed child restraint practice in China. We aim to describe the prevalence of child restraint use and investigate risk factors affecting child restraint practice in Shanghai, China.
Design And Setting:
A cross-sectional observational study was conducted near children's hospitals, kindergartens, entertainment places and shopping malls in Shanghai, China.
Participants:
Eight rounds of data were collected between October 2015 and April 2019 with a total sample size of 12 061 children.
Primary Outcome Measures:
At each site, trained field workers observed and recorded child restraint use in all passing motor vehicles with at least one child passenger.
Results:
The overall child safety restraint use rate was 6.42%. Child restraint use rate rose over time, from 5.12% in round 1% to 8.55% in round 8 (p<0.001). Results from the adjusted logistic regression model showed that children occupants with the following risk factors had a higher likelihood of child restraint use: children younger than 5 years compared with those aged 5-12 years (OR 2.12; 95% CI 1.78 to 2.53; p<0.001), sitting in rear seat compared with those in front seat (OR 31.80; 95% CI 4.45 to 227.14; p=0.001), children occupants observed near entertainment places (OR 2.34; 95% CI 1.67 to 3.28; p<0.001) or near shopping malls (OR 1.86; 95% CI 1.36 to 2.55; p<0.001) compared with those near children's hospitals and transportation in the morning compared with afternoon (OR 1.30; 95% CI 1.04 to 1.62; p=0.021).
Conclusions:
The overall child safety restraint use rate was low in Shanghai. Our findings may shed light on monitoring child restraint practice and have implications for intervention programmes for children occupants with the identified risk factors, which may help to promote child restraint use in motor vehicles and prevent road traffic injuries or deaths.
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