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    <title>Transport Research International Documentation (TRID)</title>
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    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
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    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Transport Research International Documentation (TRID)</title>
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      <title>An Overview of Road Traffic Injuries Among Children in Sweden Over 20 Years</title>
      <link>https://trid.trb.org/View/2204183</link>
      <description><![CDATA[This register study, focusing on children from (0-17 years), aimed to investigate traffic injuries (AIS1-5) among children on roads in Sweden between 2000 and 2019. The Swedish national database (STRADA) was used. It includes road traffic crashes reported by the police and by emergency care centers. The data included road user group, age, gender, injury type, AIS level, and use of seatbelt or child restraint. Descriptive statistical analysis and simple linear regression were performed to investigate significant changes in injury distribution between 2010 and 2019. A total of 14 731 registered crashes during the last 20 years involved 15 045 injured children (0-17 years). Six thousand six hundred forty-three were girls and 8088 boys. The total number of injuries decreased over time (40% since 2010). Most injured children (80%) sustained minor injuries (AIS1). Most were 12 to 17 years old (80%). A change in injury distribution was found according to age; for 0-9-year-olds, most injured children were pedestrians, while for 9-13 years old’s, bicyclists were most common. For 14- 16-year-old children, moped riders were most common. Most injured children (62%) were vulnerable road users (2000-2019). A 15% increase in the proportion of injuries between 2010 and 2019 was found. A 24% decrease in the proportion of injuries for children as vehicle occupants (excl. motorcycle and moped riders) between 2010 and 2019 was found; still, in 2019, 35% of the injured children were vehicle passengers. The most frequently injured body region was the head (26%), followed by the neck (19%). Eleven percent of the injured children in cars were unbelted. Twenty-two percent of the 0-12 years old children did not use a proper child restraint. The study confirms that Sweden's traffic safety for children (0-17 years) has improved since 2000. A 40% reduction in the number of injuries was found between 2010-2019 (including minor injuries that account for 80% of all reported injuries). The study also highlights that for vulnerable road users, the proportion of child injuries (0-17 years) increased by 15%, which was lower than vehicle occupants (24% decrease). Moped riders account for the largest road user group (35%) (2000-2019). Therefore, it is important to improve protection for children as vulnerable road users both regarding severe injuries as well as minor injuries leading to long term consequences for a safe (sustainable) traffic environment]]></description>
      <pubDate>Thu, 27 Jul 2023 16:57:03 GMT</pubDate>
      <guid>https://trid.trb.org/View/2204183</guid>
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      <title>Modelling factors that impact the use of child safety seats for nursery school travel</title>
      <link>https://trid.trb.org/View/2100424</link>
      <description><![CDATA[Children, as one of the most vulnerable road user groups, are exposed to a high risk of traffic crash-related injuries and fatalities. Children’s incomplete physical and cognitive development leads to inaccurate detection of traffic hazards and inadequate road crossing decisions. When young children travel as car occupants, their body structures are immature, and restraint over larger and sometimes different body areas is necessary. Therefore, children’s vulnerability as car occupants is subject to their age and physical development. This research investigates factors influencing child car seat usage, particularly child restraint systems or booster seats, for commuting to nursery schools. An experimental study was conducted in three suburbs of Athens, Greece, with distinctive socioeconomic status (SES) and built environment characteristics. For this purpose, a self-administered parental questionnaire was completed for 734 children attending municipality nursery schools, exploring the traffic safety practices for preschool children, child-parent interactions, the parent’s risk perception, behaviour, and knowledge of traffic safety. Responses reveal that the surveyed children—irrespective of the residence area—travel to the nursery school mainly as car occupants (89.6% overall, ranging between 84.8% for the area with the lowest SES and 96.1% for the area with the highest SES). In addition, the results indicate that three-quarters of the children are often placed in a car seat, while almost one-quarter are never restrained. Regression and structural equation models are estimated and used to examine factors affecting the usage of child safety seats. Finally, conclusions are drawn, along with suggestions to overcome the limitations and complete this research with ongoing and future data collection and analyses.]]></description>
      <pubDate>Mon, 23 Jan 2023 12:29:49 GMT</pubDate>
      <guid>https://trid.trb.org/View/2100424</guid>
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      <title>Adult’s and Children’s Attitudes Towards Extra Seat Belts in the Rear Seats</title>
      <link>https://trid.trb.org/View/1486140</link>
      <description><![CDATA[There is an increased risk of the shoulder belt slipping off in certain crash configurations, resulting in sub‐optimal protection. An extra seat belt would improve the restraint system. The objective of this study was to identify children’s and adult’s attitudes toward extra seat belts added to the three-point belt in the rear seat of a passenger car. Five focus groups were conducted with 11 Swedish children (8-10 years), and 18 adults. Two concepts were studied, the Backpack with an extra belt over the inboard shoulder, and the Criss‐Cross with an extra belt across the torso. The results showed that seat belt usage was not questioned. The three-point belt was experienced as very safe, and extra seat belts were considered to further increase safety. Both concepts were accepted, but Criss‐Cross was preferred due to greater perceived safety and comfort. Discomfort occurred in both concepts due to chafing at the neck, extra pressure on the upper body, and reduced ability to move. In conclusion, extra seat belts were in line with children’s current attitudes toward car safety, while adults were more hesitant. Increased understanding of user attitudes provides input to future restraint system design, resulting in attractive systems with improved restraint function.]]></description>
      <pubDate>Mon, 23 Oct 2017 09:36:20 GMT</pubDate>
      <guid>https://trid.trb.org/View/1486140</guid>
    </item>
    <item>
      <title>Child passenger kinematics in emergency manoeuvres</title>
      <link>https://trid.trb.org/View/1367661</link>
      <description><![CDATA[In motor vehicle impacts, a child’s head is generally the most frequently injured body region, irrespective of impact direction. Head to front seat back impact has been identified as a predominant cause of injury for rear seated, seat belt restrained children, aged 3 ‐ 13, who sustained AIS2+ head injuries in frontal impacts. Previous research highlights vehicle manoeuvres prior to impact as possible contributing factors. Test tools to simulate occupant kinematics during emergency braking and steering manoeuvres would be valuable when investigating different scenarios and restraint systems. This thesis investigates children’s and different Anthropomorphic Test Devices’ (ATDs’) motion during emergency braking and steering manoeuvres in a passenger vehicle. The kinematic responses of child volunteers during the emergency manoeuvres in different restraint configurations were compared and discussed, and the current child ATDs from the Q-family and the Hybrid III (HIII) family were evaluated with respect to child occupants. The forward displacement was within the same range during the braking manoeuvres for all tested children, regardless of size and restraint system. All ATDs displayed less forward displacement and head rotation than the child volunteers; the HIII 6 year old on a booster cushion was closest to representing the kinematics of a child of similar age/size in this set-up. Maximum excursion was dependent on the initial seated posture and shoulder belt position on the shoulder. Boosters with a backrest influenced the initial seated posture and thus resulted in the head position being more forward during maximum excursion. For the steering manoeuvres, the Q ATDs were closer regarding mean values compared to the children, however due to the large variety in lateral displacements of the children, the child performance range covers both the dummy families for the evaluated sizes of 6 and 10 year old ATDs in this set-up. The braking and steering manoeuvres with child volunteers and ATDs carried out in this thesis provide novel and unique knowledge of possible pre-crash postures of children and currently available ATDs across a variety of restraint systems in vehicle emergency manoeuvres. The test methods and methods of analysis were repeatable and the results offer input to safety system development, ATD design as well as test method development. Appropriate initial shoulder belt position is important during steering and braking manoeuvres. For real world protection, it is important to take into account the growing child, focusing on and understanding such aspects as initial seated posture, i.e., head position, shoulder belt position and how the child is restrained by the seat belt, as well as the booster design.]]></description>
      <pubDate>Tue, 01 Sep 2015 11:21:09 GMT</pubDate>
      <guid>https://trid.trb.org/View/1367661</guid>
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    <item>
      <title>Preventing Pediatric Out‐of‐Position in Frontal Crashes: Impact Assessment of a Head Support System</title>
      <link>https://trid.trb.org/View/1326067</link>
      <description><![CDATA[Head injuries are the most frequent and severe injuries sustained by children in motor vehicle crashes regardless of age, restraint type and direction of impact force. Recent investigations have shown that these injuries are likely related to the direct contact of the head with the interior components of the vehicle. The present study evaluates the impact performance of a device intended to provide head support to children with problems to control the position of the head. Twenty‐three crash tests with a nominal impact speed of 50 km/h were performed in a decelerator sled according to European regulation ECE R44/04. Two different sizes of dummies (P3, P6) were used in the evaluation. Three different child restraint systems (CRS) were considered: a forward‐facing seat with ISOFIX and top tether (P3 dummy), a high‐back booster seat with ISOFIX (P3 and P6 dummies) and a high‐back booster seat (P3). It was observed that the use of the device did not influence significantly the kinematics of the dummies. Even if the system modified slightly the trajectory of the head, it did not cause substantial changes in the magnitude of the head and chest accelerations. All the dummy parameters fell well within the limits established by the regulation. Thus, given that other studies have shown that the head support system is effective preventing out‐of‐position, the results presented here suggest that the use of the system can contribute to improve the overall safety of pediatric occupants by diminishing the incidence of out‐of‐position events without altering the protection given by the CRS in frontal impacts.]]></description>
      <pubDate>Fri, 31 Oct 2014 10:59:13 GMT</pubDate>
      <guid>https://trid.trb.org/View/1326067</guid>
    </item>
    <item>
      <title>Review of Child Car Occupant Fatalities in Sweden During Six Decades</title>
      <link>https://trid.trb.org/View/1328318</link>
      <description><![CDATA[The development of fatal outcome was reviewed based on crash data including all fatally injured 0–14 year old car occupants in Sweden during 1956–2011 and put in relation to general  improvements in vehicle and road safety and implementation of restraint systems. The review revealed a substantial decrease in crash‐related fatalities among 0–14 year old car occupants during the past three decades, representing a significant drop of 83% compared to the highest scores in the 1960s–70s. During 1992–2011, a total of 194 crash‐related fatalities were registered; the majority occurred on high‐speed roads. Head injury was a primary cause of death, in a total of 54% of all cases. Two fifths of the crashes involved a single car, while three fifths involved other vehicles. In total, 24% of the children were unrestrained, and 59% of those were ejected during crashes. Among the restrained children, 56% were considered to be appropriately restrained according to Swedish recommendations. Crash severity, complex crash situation, fire and drowning were factors that contributed to the fatal outcome, even though the restraint usage was considered to be optimal.]]></description>
      <pubDate>Fri, 31 Oct 2014 10:59:13 GMT</pubDate>
      <guid>https://trid.trb.org/View/1328318</guid>
    </item>
    <item>
      <title>Older Children’s Sitting Postures, Behaviour and Comfort Experience during Ride – A Comparison
between an Integrated Booster Cushion and a High‐Back Booster</title>
      <link>https://trid.trb.org/View/1328320</link>
      <description><![CDATA[Sitting postures and comfort experience were analysed from six children aged 7‐9 (131‐145 cm) seated on an Integrated Booster Cushion (IBC) and a high‐back Booster (hbB) during 1 hour on‐road drives, respectively. Data were collected from video recordings, questionnaires and interviews. When seated on the IBC the most frequent posture was with the entire back and shoulders against the seat back and the head upright. On the hbB, the shoulders were seldom against the backrest. The most frequent lateral sitting posture for both boosters was upright with the seat belt in contact with the neck or mid‐shoulder. Moderate and extreme forward and lateral postures occurred occasionally. A positive attitude was found towards the IBC due to possibilities to move freely, the soft seat cushion and the absence of torso supports, but the short seat cushion created some inconvenience. The hbB was perceived hard, created a locked‐in feeling and felt unpleasant due to movements when changing postures. The combination of objective and subjective measures provided valuable information regarding children’s sitting behaviour. It is obvious that children do not always sit in on‐road drives as in crash tests. Their activities and perceived discomfort influenced the selection of sitting posture and seat belt positions.]]></description>
      <pubDate>Fri, 31 Oct 2014 10:59:13 GMT</pubDate>
      <guid>https://trid.trb.org/View/1328320</guid>
    </item>
    <item>
      <title>Car safety for children aged 4-12: real world evaluations of long-term injury outcome, head injury causation scenarios, misuse, and pre-crash maneuver kinematics</title>
      <link>https://trid.trb.org/View/1263438</link>
      <description><![CDATA[Child casualties in car crashes have decreased over the years.  Nevertheless, occupant safety in rear seats, especially for children 4-12 years old, needs further attention because motor vehicle crashes remain the leading cause of death and long-term health consequences for children.  The aim of this thesis was to obtain comprehensive knowledge of real-life situations for restrained, forward-facing, rear-seated children aged 4-12 years, in frontal car crashes as a basis for vehicle safety improvements to reduce long-term health consequences.   The thesis is comprised of four studies based on child-specific data from Sweden and the US.  Study I was based on injury data from insurance claim files, covering 2619 injured children in Sweden.  Study II was an experimental study of restraint misuse, including 130 Swedish children.  Study III analyzed crash data included 27 cases from two US databases, to determine injury causation scenarios.  Study IV was a driving study of how pre-crash maneuvers affect child occupant kinematics with 16 children included.  In conclusion, the primary recommendation as a result of this research is to protect the head and neck of child occupants from both minor and severe injuries, since all severity levels of injuries may result in long-term consequences.  Frontal impacts, including oblique impacts or maneuvers prior to impact, need to be addressed to develop &ldquo;tolerant&rdquo; restraint systems.  Furthermore, it is recommended to design and use vehicle-built-in restraint systems to improve crash safety among children, by facilitating proper use of the restraint and placement on the child, as has been previously done for front-seated adults.  To incentivize vehicle manufacturers to accelerate the implementation of child safety improvements within their vehicles, an assessment of child safety for 4-12-year-old children should be included in consumer rating programs and legal requirements.]]></description>
      <pubDate>Wed, 25 Sep 2013 11:51:36 GMT</pubDate>
      <guid>https://trid.trb.org/View/1263438</guid>
    </item>
    <item>
      <title>United Kingdom accident experience with restrained children</title>
      <link>https://trid.trb.org/View/1183087</link>
      <description><![CDATA[]]></description>
      <pubDate>Fri, 24 Aug 2012 04:27:33 GMT</pubDate>
      <guid>https://trid.trb.org/View/1183087</guid>
    </item>
    <item>
      <title>Child protection in cars: experiences and problems</title>
      <link>https://trid.trb.org/View/1183086</link>
      <description><![CDATA[]]></description>
      <pubDate>Fri, 24 Aug 2012 04:27:32 GMT</pubDate>
      <guid>https://trid.trb.org/View/1183086</guid>
    </item>
    <item>
      <title>Child restraint devices in France: actual use and possible consequences on their efficiency</title>
      <link>https://trid.trb.org/View/1183085</link>
      <description><![CDATA[]]></description>
      <pubDate>Fri, 24 Aug 2012 04:27:31 GMT</pubDate>
      <guid>https://trid.trb.org/View/1183085</guid>
    </item>
    <item>
      <title>Child restraints in Europe</title>
      <link>https://trid.trb.org/View/1183084</link>
      <description><![CDATA[]]></description>
      <pubDate>Fri, 24 Aug 2012 04:27:30 GMT</pubDate>
      <guid>https://trid.trb.org/View/1183084</guid>
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    <item>
      <title>Proceedings of Road Safety in Europe in Gothenburg, Sweden, 12-14 October 1988: Complimentary aspects on road safety; Children in cars - workshop</title>
      <link>https://trid.trb.org/View/1182904</link>
      <description><![CDATA[]]></description>
      <pubDate>Fri, 24 Aug 2012 04:23:27 GMT</pubDate>
      <guid>https://trid.trb.org/View/1182904</guid>
    </item>
    <item>
      <title>Protection effects of child restraints: experiences from accidents and sled tests with carry cots</title>
      <link>https://trid.trb.org/View/1178638</link>
      <description><![CDATA[]]></description>
      <pubDate>Fri, 24 Aug 2012 01:54:36 GMT</pubDate>
      <guid>https://trid.trb.org/View/1178638</guid>
    </item>
    <item>
      <title>SICHERHEIT VON KINDERN IM KRAFTFAHRZEUG - EINSATZ VON RUECKHALTEEINRICHTUNGEN FUER KINDER IN SCHWEDEN</title>
      <link>https://trid.trb.org/View/1009853</link>
      <description><![CDATA[Der vorliegende Bericht beschreibt die Entwicklung von Rueckhaltesystemen  in Schweden fuer im Auto mitgenommene Kinder. Die einschlaegige Unfallstatistik, Gesetzgebung, Genehmigungsvorschriften, Aufklaerungsmassnahmen und die Wirksamkeit unterschiedlicher Konzeptionen werden eroertert. Leihsysteme fuer Babytragetaschen und rueckwaerts gerichtete Kindersitze, die in Schweden zur Zeit noch als einzigartig gelten, werden vorgestellt und beschrieben. (A) Siehe auch IDS-Nummer 328006.]]></description>
      <pubDate>Sat, 20 Nov 2010 04:49:25 GMT</pubDate>
      <guid>https://trid.trb.org/View/1009853</guid>
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