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Car restraints and seating position for prevention of motor vehicle injuries in Greece
E Petridou1, A Skalkidou, I Lescohier
1Department of Hygiene and Epidemiology, Athens University Medical School, Greece.
Insights
Child car seats significantly reduce injuries, with unrestrained children being 3.3 times more likely to be injured. Rear seating offers protection, but proper child restraints are crucial for preventing two-thirds of childhood car crash injuries.
Area of Science:
- Pediatric Injury Prevention
- Traffic Safety Research
- Epidemiology
Background:
- Child passenger safety is a critical public health concern.
- Many children travel unrestrained in vehicles, increasing injury risk.
- Understanding the impact of restraint use and seating position is vital for targeted interventions.
Purpose of the Study:
- To assess the protective effect of child restraints.
- To evaluate the relative safety of front versus rear seating positions for children.
- To inform child passenger safety policies in Greece.
Main Methods:
- Population-based case-control study of 129 injured child passengers (0-11 years) in Athens.
- Exposure prevalence estimated via a survey of 191 children in passenger cars.
- Adjusted odds ratios (ORs) calculated using the Mantel-Haenszel procedure.
Main Results:
- Unrestrained children had an OR of 3.3 for injury compared to restrained children (primarily 0-4 years).
- Children in front seats had an OR of 5.0 for injury compared to rear seats (primarily unrestrained).
- Regular use of child restraints could prevent approximately two-thirds of childhood car crash injuries in Greece.
Conclusions:
- Child restraints offer significant protection against car crash injuries.
- Rear seating provides substantial protection for children when restraints are absent.
- Implementing consistent child restraint use is essential for reducing childhood traffic fatalities and injuries.
Abstract:
The protective effect of child restraint and the relative safety of front and rear seating in a population where children often travel unrestrained was assessed in a population based case-control study. The cases were all 129 children aged 0-11 years injured as car passengers in a motor vehicle accident who contacted, during 1996, one of the two major children's hospitals in Athens; emergency cases are accepted by the two hospitals on alternate days throughout the year, thus generating a random sample of children injured as car passengers. The prevalence of the studied exposures in the study base was estimated from an inspection survey comprising a random sample of 191 children of the same age who travelled in passenger cars. The survey was conducted by medical staff from our centre in collaboration with the road traffic police. Odds ratios (ORs) were calculated after adjustment for confounding factors through the Mantel-Haenszel procedure. The OR for injury was 3.3 among unrestrained children compared with restrained children (comparison essentially limited to children aged 0-4 years) and 5.0 for children seated in the front compared with those seated in the rear (comparison essentially limited among unrestrained children). Protective effect estimates derived from this analytical study suggest that in Greece about two thirds of all childhood injuries from car crashes could have been avoided through the regular use of a proper child restraint. The data also indicate that, in the absence of a child restraint system, a rear seating position conveys substantial protection and could explain the low mortality of children as car passengers in Greece, a country which is characterised by a high overall road traffic mortality as well as a high childhood accident mortality.