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Safety seat and seat belt use among child motor vehicle occupants, Cluj-Napoca, Romania
  1. Diana Dulf1,
  2. Corinne Peek-Asa2,
  3. Florin Jurchiș1,3,
  4. Erika-Andrada Bărăgan1
  1. 1 Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
  2. 2 Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
  3. 3 Faculty of Economics and Business Administration, Babes-Bolyai University, Cluj-Napoca, Romania
  1. Correspondence to Mrs Diana Dulf, Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca 400084, Romania; diana.dulf{at}


Background Use of seat belts and car seats for children are among the most effective interventions to reduce injury severity when a crash occurs. The use should be enforced in order to have an increase in wearing these restraints. Romania has the lowest rate of using seatbelts in the backseat, 16%. The purpose of the study is to describe the use of child safety restraints and compare it with existing standards of good practice.

Methods An observational study on child safety restraint was conducted in Cluj-Napoca, Romania, between 2013 and 2014. Observational sites included 38 schools and kindergartens and three commercial areas, where drivers (n=768) and child passengers (n=892) were observed. Observations were conducted as vehicles parked or pulled to a stop and were followed by driver surveys on knowledge and attitudes towards restraint legislation and child safety behaviour as car occupants.

Results The proportion of observed child motor vehicle occupants wearing some type of restraint was 67.4% (n=601). The majority of children (82.6%) were in the back seat, and 14.2% of infants were in a rear-facing child seat. The proportion of restrained children declined with age, with children 5 years old or younger being almost five times more likely to be properly restrained (OR 4.87, 95% CI 2.93 to 8.07) when compared with older children.

Conclusions Although minimum legal requirements of child motor vehicle occupant safety were in place in Romania at the time of the study, the rates of using children restraints was low compared with other middle-income and high-income countries.

  • restraints
  • motor vehicle occupant
  • surveys
  • child

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  • Funding Funding was provided by the NIH-Fogarty International Trauma Training Program at the University of Iowa (5D43TW007261).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.