190980 Booster seat and seat belt effectiveness among children ages 4-8

Tuesday, October 28, 2008

Thomas M. Rice, MPH, PhD , Department of Environmental Health Services, University of California Berkeley, Berkeley, CA
Craig L. Anderson, DHSc, PhD , Department of Emergency Medicine, University of California Irvine, Orange, CA
Background: Numerous studies have examined booster seat usage among young children or have evaluated interventions to increase booster seat use. Few studies have estimated the effectiveness of booster seat use on injury or fatality risk due to the difficulty in obtaining restraint use data, particularly in the absence of injury.

Methods: We estimated the effectiveness of booster seat use in preventing fatal injury among children ages 4-8 using a matched cohort study of Fatality Analysis Reporting System data for years 1996-2006. Death risk ratios were estimated with conditional Poisson regression, and coefficient standard errors were bootstrapped.

Results: The estimated death risk ratios comparing booster seat use to traveling unrestrained were 0.39 (95% CI 0.32 - 0.47) for children ages 4 or 5 and 0.54 (0.39 - 0.76) for ages 6, 7, or 8. Seat belt risk ratios were 0.40 (0.33 - 0.47) for ages 4 or 5 and 0.46 (0.40 - 0.53) for ages 6, 7, or 8. Both restraints were more effective during rollover collisions and collisions in rural areas. Effectiveness did not appear to vary by model year or calendar year.

Conclusions: This study found that booster seats and ordinary seat belts are approximately equal in their effectiveness in reducing death risk among children ages 4-8 during severe traffic collisions. This analysis did not examine non-fatal injury, but several published studies have reported boosters to be more effective than seat belts in preventing non-fatal injury. Clinical and public health practitioners should advocate for the use of booster seats over seat belts.

Learning Objectives:
1. Describe a matched-set cohort study 2. Describe the associations between booster seat use and seat belt use with the risk of death among children ages 4-8 during severe traffic collisions 3. Identify collision and vehicle factors that influence the effectiveness of booster seats among children ages 4-8

Keywords: Children, Motor Vehicles

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed, obtained funding for, and directed the research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.