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Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway
BACKGROUND: Use of appropriate child passenger safety restraints reduces injury in infants, with rear facing restraints favored over forward facing. In 2011, the American Academy of Pediatrics (AAP) began recommending that infants and children under the age of 2 years be restrained in a rear-facing...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616467/ https://www.ncbi.nlm.nih.gov/pubmed/31333994 http://dx.doi.org/10.1186/s40621-019-0200-4 |
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author | Huang, Yu-Yun Liu, Chang Pressley, Joyce C. |
author_facet | Huang, Yu-Yun Liu, Chang Pressley, Joyce C. |
author_sort | Huang, Yu-Yun |
collection | PubMed |
description | BACKGROUND: Use of appropriate child passenger safety restraints reduces injury in infants, with rear facing restraints favored over forward facing. In 2011, the American Academy of Pediatrics (AAP) began recommending that infants and children under the age of 2 years be restrained in a rear-facing seat installed in the vehicle’s rear seat. This study examines the practice of rear-facing restraints pre- and post-AAP recommendations for children under 2 years. METHODS: Data from the Fatality Analysis Reporting System (FARS) from 2008 to 2015 were used to examine restraint status and injuries in rear-seated infants and toddlers aged 0 to less than 2 years involved in fatal collisions (n = 4966). Subpopulation analyses were conducted on 1557 children with seat facing direction recorded. Multivariable logistic regression was used to generate odds ratios (OR) with 95% confidence intervals (CI). Covariates considered for inclusion in the multivariable model included passenger characteristics (age, gender, seating position), driver characteristics (age, gender, seat belt status, alcohol status, drug status, previous traffic violations), vehicle characteristics (vehicle type), and crash-level characteristics (day/night, weekday/weekend, rush hour, expressway/surface street, urban/rural). RESULTS: Approximately 6.7% (330 of 4996) of infants and toddlers were unrestrained with mortality that was approximately triple that of restrained infants (40.0% vs 13.7%, P < 0.0001). In multivariable adjusted models, predictors of an infant being unrestrained included unrestrained driver (OR: 3.17, 95% CI: 2.38–4.21), driver aged less than 20 years (OR: 2.18, 95% CI: 1.42–3.34), driver alcohol use (OR: 2.21, 95% CI: 1.42–3.44), center-seated infant (OR: 1.55, 95% CI: 1.19–2.03) and weekday crash (OR: 1.52, 95% CI: 1.12–2.01). Of all rear-seated children whose restraint status were reported (4966), rear-facing restraint use increased from 5.0% to 23.2% between 2008 and 2015 (P < 0.0001). The odds of rear-facing restraint use increased after introduction of the AAP guideline among infants aged 0 to < 1 year old (OR: 2.12, 95% CI: 1.46–3.10) and among toddlers aged 1 to < 2 years old (OR: 1.97, 95% CI: 1.03–3.79). CONCLUSION: Trends in the use of rear-facing child restraints improved over the timeframe of this study, but remain low despite the introduction of AAP guidelines and the strengthening of child restraint laws. |
format | Online Article Text |
id | pubmed-6616467 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66164672019-07-22 Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway Huang, Yu-Yun Liu, Chang Pressley, Joyce C. Inj Epidemiol Research BACKGROUND: Use of appropriate child passenger safety restraints reduces injury in infants, with rear facing restraints favored over forward facing. In 2011, the American Academy of Pediatrics (AAP) began recommending that infants and children under the age of 2 years be restrained in a rear-facing seat installed in the vehicle’s rear seat. This study examines the practice of rear-facing restraints pre- and post-AAP recommendations for children under 2 years. METHODS: Data from the Fatality Analysis Reporting System (FARS) from 2008 to 2015 were used to examine restraint status and injuries in rear-seated infants and toddlers aged 0 to less than 2 years involved in fatal collisions (n = 4966). Subpopulation analyses were conducted on 1557 children with seat facing direction recorded. Multivariable logistic regression was used to generate odds ratios (OR) with 95% confidence intervals (CI). Covariates considered for inclusion in the multivariable model included passenger characteristics (age, gender, seating position), driver characteristics (age, gender, seat belt status, alcohol status, drug status, previous traffic violations), vehicle characteristics (vehicle type), and crash-level characteristics (day/night, weekday/weekend, rush hour, expressway/surface street, urban/rural). RESULTS: Approximately 6.7% (330 of 4996) of infants and toddlers were unrestrained with mortality that was approximately triple that of restrained infants (40.0% vs 13.7%, P < 0.0001). In multivariable adjusted models, predictors of an infant being unrestrained included unrestrained driver (OR: 3.17, 95% CI: 2.38–4.21), driver aged less than 20 years (OR: 2.18, 95% CI: 1.42–3.34), driver alcohol use (OR: 2.21, 95% CI: 1.42–3.44), center-seated infant (OR: 1.55, 95% CI: 1.19–2.03) and weekday crash (OR: 1.52, 95% CI: 1.12–2.01). Of all rear-seated children whose restraint status were reported (4966), rear-facing restraint use increased from 5.0% to 23.2% between 2008 and 2015 (P < 0.0001). The odds of rear-facing restraint use increased after introduction of the AAP guideline among infants aged 0 to < 1 year old (OR: 2.12, 95% CI: 1.46–3.10) and among toddlers aged 1 to < 2 years old (OR: 1.97, 95% CI: 1.03–3.79). CONCLUSION: Trends in the use of rear-facing child restraints improved over the timeframe of this study, but remain low despite the introduction of AAP guidelines and the strengthening of child restraint laws. BioMed Central 2019-05-29 /pmc/articles/PMC6616467/ /pubmed/31333994 http://dx.doi.org/10.1186/s40621-019-0200-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Huang, Yu-Yun Liu, Chang Pressley, Joyce C. Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway |
title | Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway |
title_full | Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway |
title_fullStr | Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway |
title_full_unstemmed | Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway |
title_short | Restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a U. S. Roadway |
title_sort | restraint use and injury in forward and rear-facing infants and toddlers involved in a fatal motor vehicle crash on a u. s. roadway |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616467/ https://www.ncbi.nlm.nih.gov/pubmed/31333994 http://dx.doi.org/10.1186/s40621-019-0200-4 |
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