Brief communication and researsh noteChild safety seat misuse patterns in four states
Abstract
Child safety seat misuse is still a concern in the nation. This paper addresses the patterns of child safety seat (CSS) misuse and reports on the techniques used to effectively collect this data. CSS use and misuse observations were collected for 5900 target young children (under 27 kg or 60 pounds) in over 4000 vehicles in four states: Mississippi, Missouri, Pennsylvania and Washington. Results showed overall CSS use for target children was 50.6%. Only 12.8% of these children were unrestrained, with the remainder were restrained in safety belts. Correct CSS use was defined as proper use of all of the following CSS elements: seat direction, vehicle safety belt routing, harness buckle and harness strap, harness retainer (chest) clip, and locking clip (on safety belt). Overall correct CSS use was 20.5%. For infants (children under 9 kg or 20 pounds), 96.6% were in a CSS and 20.6% of these were correctly used. For toddlers (children between 9 and 18 kg or 20 and 40 pounds), 67.5% were in a CSS and 18.9% of these were correctly used. For pre-school children (between 18 and 27 kg or 40 and 60 pounds), 6.1% were in a CSS and 50% of these were correctly used. The strongest positive relationship between target child restraint use and CSS proper use was for drivers using safety belts. Other positive relationships were found for the vehicle having air bags, the driver being a family member, the child in the middle back seat position, and CSS infrequently removed from the vehicle.
References (14)
- L.E. Decina et al.
Increasing child safety seat use and full protection among toddlers: evaluation of an enforcement program
Accident Analysis and Prevention
(1994) - D. Bulger
A hospital-based child passenger restraint program
Journal of Traffic Safety Education
(1983) - M. Bull et al.
Misuse of car safety seats
Pediatrics
(1988) - M.J. Cynecki et al.
The incidence and factors associated with child safety seat misuse
- L.E. Decina et al.
Local police enforcement, public information and education strategies to foster the use of child safety seats for toddlers: evaluation of a demonstration project
- NHTSA (National Highway Traffic Safety Administration)
Occupant protection trends in nineteen cities in October 1990
(1991) - NHTSA (National Highway Traffic Safety Administration)
Cited by (100)
Influence of seat belt use behavior and road traffic crash experience on the use of child restraint systems: A step further
2024, Journal of King Saud University - Engineering SciencesSeat belts and child restraint systems (CRS) are important in-car safety components capable of preventing serious injuries and death in the event of a car crash. Low rates of seat belt and CRS use persist globally, particularly in the Kingdom of Saudi Arabia (KSA). In an effort to better understand and subsequently improve seat belt and CRS use rates, this study analyzed the factors influencing seat belt and CRS use behavior in the Eastern Province (EP) of KSA, including the connection between seat belt and CRS use and road traffic crash experience.
This cross-sectional study was based on a survey of 3,421 male and female participants regarding their seat belt and CRS use behavior. Respondents were classified into four CRS use categories: cautious, helplessly negligent, ignorantly negligent, and deliberately negligent. Chi-squared tests were used to determine significant associations among seat belt use, seat belt belief, prior crash experience, CRS use, and demographic variables. Multinomial nominal logistic regression was used to estimate the odds ratios for classification in one of the three negligent vs. cautious CRS use categories as a function of demographic variables, prior road traffic crash experience, and belief in and use of seat belts.
Results of this study indicated a modest improvement in the rate of seat belt use in KSA’s EP, however, a significant proportion of respondents reported only sometimes or never using their seat belt. A significant proportion of respondents were also classified in one of the three negligent CRS use categories. Respondents who reported using a seat belt sometimes or never were 2.67, 2.60, and 3.48 times more likely to be categorized as deliberately negligent, ignorantly negligent, or helplessly negligent in their CRS use, respectively, than respondents who reported always using their seat belts. Respondents who reported being previously involved in a car crash or a near crash were also more likely to be classified in one of the three negligent CRS use categories than respondents who reported no prior road traffic crash experience. Previous involvement in a car crash was also found to be associated with lower seat belt and CRS use rates.
These findings suggest a need for increased seat belt law enforcement by the KSA’s Traffic Police Department, as well as additional seat belt and CRS use awareness campaigns targeting individuals with prior road traffic crash experience by the KSA’s Ministry of Communications through the Road Transport Department. This study can serve as a reference for future studies that aim to understand the factors and implications related to seat belt use and belief, CRS use, and road traffic crash experience.
An assessment of child passenger safety levels of service in Michigan
2019, Traffic Injury PreventionObjective: The purpose of this article was to assess the match between child passenger safety resources (child passenger safety technicians [CPSTs], car seat checks, and child restraint system [CRS] distribution programs) and the child population in Michigan by utilizing geographic information systems approaches and to analyze the impact of Michigan’s CPSTs on child passenger safety behaviors on departure from a seat check.
Methods: Data were collected from administrative sources and a survey of CPSTs to determine the number and location of child passenger safety resources and children in Michigan. The main analyses used data from 2014. The child population ≤4 years old per county and per traffic safety region was determined from census data. CPST and car seat check locations were determined from a list from the Michigan Office of Highway Safety Planning (Mi-OHSP) and a survey of CPSTs who coordinate seat checks. Summary sheets from Mi-OHSP served as the data source for CRSs distributed through their occupant protection program. Data from child passenger safety checklists completed with seat checks were obtained from Safe Kids Michigan. Addresses were geocoded using Google Maps Geocoding API and then mapped at the county level using ArcGIS Desktop 10.3.1. Descriptive statistics were calculated and levels of service were determined at the county and regional levels.
Results: In 2014, there were 570,929 children ≤4 years old in Michigan and 979 CPSTs who worked at 209 known seat check locations. An average of 6,854 seats was checked per year through Safe Kids Michigan Coalitions. All but 3 regions met an intermediate service level for seat check locations by offering one or more per 5,000 children ≤4 years old. There was at least one CPST in 80 of 83 counties (median 5; interquartile range, 2, 10.5). Assuming that an average Michigan CPST provides 10 h of service each year, all but 2 regions reached an intermediate service level of at least one technician hour per 90 children ≤4 years old. Fewer regions reached a basic level of service for the number of seat checks. Almost half (49.5%) of Safe Kids Michigan seat checks resulted in a change in child passenger safety behaviors.
Conclusions: Child passenger safety resources in Michigan are not evenly distributed yet most regions and counties meet intermediate levels of service. Reallocating resources to areas that are providing basic levels of service could help reduce disparities in child passenger safety behaviors.
Observational study of child restraining practice on Norwegian high-speed roads: Restraint misuse poses a major threat to child passenger safety
2013, Accident Analysis and PreventionRestraint misuse and other occupant safety errors are the major cause of fatal and, severe injuries among child passengers in motor vehicle collisions. The main objectives of the present, study were to provide estimates of restraining practice among children younger than 16 years, traveling on Norwegian high-speed roads, and to uncover the high-risk groups associated with, restraint misuse and other safety errors.
A cross-sectional observational study was performed in conjunction with regular traffic, control posts on high-speed roads. The seating and restraining of child occupants younger than 16, years were observed, the interior environment of the vehicles was examined, and a structured, interview of the driver was conducted according to a specific protocol.
In total, 1260 child occupants aged 0–15 years were included in the study. Misuse of restraints, was observed in 38% of cases, with this being severe or critical in 24%. The presence of restraint, misuse varied significantly with age (p < 0.001), with the frequency being highest among child, occupants in the age group 4–7 years. The most common error in this group was improperly routed, seat belts. The highest frequency of severe and critical errors was observed among child occupants in, the age group 0–3 years. The most common errors were loose or improperly routed harness straps and, incorrect installations of the child restraint system. Moreover, 24% of the children were seated in, vehicles with heavy, unsecured objects in the passenger compartment and/or the trunk that were, likely to move into the compartment upon impact and cause injury. No totally unrestrained children, were observed.
This study provides a detailed description of the characteristics of restraint misuse and, the occupant's exposure to unsecured objects. Future education and awareness campaigns should, focus on children aged <8 years. The main challenges are to ensure correct routing and tightness of, harness straps and seat belts, correct installation of child restraints, and avoidance of premature, graduation from child restraints to seat belts only. Information campaigns should also advocate the use, of chest clips and address the potential risks of hard, heavy objects in the passenger compartment and, the importance of the placement and strapping of heavy objects in the trunk.
Parents' attitudes, knowledge and behaviours relating to safe child occupant travel
2013, Accident Analysis and PreventionThis study investigated parents’ attitudes, knowledge and behaviours relating to safe child occupant travel following new Australian legislation regarding child restraint system (CRS) and motor vehicle restraint use for children aged 7 years and under. A questionnaire exploring attitudes, knowledge and behaviours regarding general road safety, as well as safe child occupant travel, was completed by 272 participants with at least one child aged between 3 and 10 years residing in the Australian state of Victoria. Responses to the questionnaire revealed that participants’ attitudes, knowledge and behaviours towards road safety in general were fairly positive, with most participants reporting that they restrict their alcohol consumption or do not drink at all while driving (87%), drive at or below the speed limit (85%) and ‘always’ wear their seatbelts (98%). However, more than half of the participants reported engaging in distracting behaviours ‘sometimes’ or ‘often’ (54%) and a small proportion of participants indicated that they ‘sometimes’ engaged in aggressive driving (14%). Regarding their attitudes, knowledge and behaviours relating to safe child occupant travel, most participants reported that they ‘always’ restrain their children (99%). However, there was a surprisingly high proportion of participants who did not know the appropriate age thresholds’ to transition their child from a booster seat to an adult seatbelt (53%) or the age for which it is appropriate for their child to sit in the front passenger seat of the vehicle (20%). Logistic regression analyses revealed that parents’ knowledge regarding safe child occupant travel was significantly related to their attitudes, knowledge and behaviours towards road safety in general, such as drinking habits while driving and CRS safety knowledge. Based on the findings of this study, a number of recommendations are made for strategies to enhance parents’ attitudes, knowledge and behaviours relating to safe child occupant travel, as well as for future research.
Grandparents and child passenger safety
2012, Accident Analysis and PreventionCitation Excerpt :At that time the authors suggested that grandparents had less access to CSS. Decina and Knoebel (1997) observed CSS misuse in four states and examined the relationship of driver, child passenger, and CSS misuse. Their results showed no significant difference in CSS use and misuse and CSS use was higher among parent and grandparent compared to non-family members.
This study compares child passenger safety (CPS) practices of grandparents versus parents and determines grandparents’ opinions on car safety seats (CSS), barriers to use, and ways to transport grandchildren safely.
Observational surveys were conducted on a convenience sample of drivers transporting children younger than sixteen years at 25 locations by certified child passenger safety technicians observing children in motor vehicles and recorded use of child passenger restraints. The drivers were surveyed on their knowledge, attitudes, beliefs, and practices regarding CPS. Data from drivers identifying themselves as grandparents were analyzed; also, three grandparent focus groups provided opinions on CPS practices.
During the study 1758 parents transporting 2713 children and 284 grandparents transporting 391 grandchildren were included. While most drivers were restrained and used child occupant restraints, almost 25% of parents and grandparents chose the incorrect seat to transport the child, and greater than 68% had at least one harness error. Grandparents were more likely to have looser lower anchor straps or seat belts and have children younger than thirteen years in the front seat.
The focus group-grandparents had a favorable attitude toward CSS. Grandparents acknowledged the need for CSS but opined that CSS were difficult to use. Physical barriers included arthritis, back pain, mobility, decreased strength, and vision problems.
Grandparents and parents were equally likely to use CSS and choose correct seats. Compared to parents, grandparents were more likely to travel with their grandchildren with CSS installed with looser harnesses or an installed CSS with looser seat belt or lower anchors. Additionally, grandparents were more likely to have a child younger than thirteen years in the front seat. The use of community resources such as permanent fitting stations could help grandparents improve a grandchild's travel safety.
A numerical investigation into the effect of CRS misuse on the injury potential of children in frontal and side impact crashes
2011, Accident Analysis and PreventionThis research focuses on an investigation into the head and neck injuries sustained by toddlers due to CRS misuse under frontal and side impact crashes. A fully deformable FE model incorporating a Hybrid III 3-year-old dummy was developed which has been previously validated for frontal impacts under CMVSS 208 and FMVSS 213 testing conditions. Furthermore, this model has also been validated under near-side impact conditions in accordance to crash tests carried out by NHTSA. In addition, numerical models incorporating a Q3/Q3s prototype child crash test dummies were developed. The objective of this research was to study the effect of seatbelt slack and the absence of the top tether strap on the head and neck injuries sustained by toddlers in a vehicle crash. Numerical simulations were conducted under full frontal and near side impact crash testing conditions in accordance with FMVSS 213 for the Hybrid III 3-year-old dummy and Q3/Q3s dummies in the absence and presence of slack in the seatbelt webbing, and in the absence and presence of the top tether strap. In addition, the effect of using a cross-shaped rigid ISOFIX system was also investigated. An analysis of the head and chest accelerations, neck loads and moments was completed to investigate the potential of injury due to CRS misuse. An increase in HIC15 by approximately 30–40% for the frontal impact and 10–20% for the near-side impact respectively was observed for the Q3 child dummy due to both forms of CRS misuse. In the absence of the top tether strap the forward head excursions were observed to be increased by approximately 70% for the Hybrid III 3-year-old dummy and 40% for the Q3 dummy, respectively. Use of the cross-shaped rigid ISOFIX system illustrated a reduction in head and neck injury parameters, for both frontal and side impact conditions, in the absence and presence of CRS misuse. CRS misuse results in a significant increase in injury parameters and potential for contact related head injuries. Use of a rigid ISOFIX system to restrain a CRS provides better CRS and dummy confinement and reduced injury potential than a flexible ISOFIX system.