Effectiveness of booster seats compared with no restraint or seat belt alone for crash injury prevention

Evaluating the effectiveness of belt-positioning booster seats, compared with no restraint use and with seat belt use only, during motor vehicle crashes among U.S. children, was the objective of this study. This retrospective matched cohort study used data from the 1998 through 2009 National Automotive Sampling System (NASS) Crashworthiness Data System (CDS). Children aged 0 to 10 years who were not seated in the front seat of the vehicle comprised the study sample. The authors used Cox proportional hazards models to estimate the risk of overall, fatal, and regional body injury. The results show that less overall injury was experienced by children using seat belts in belt-positioning booster seats (Injury Severity Score [ISS] > 0, adjusted risk ratio [RR] = 0.73, 95% confidence interval [CI] = 0.55 to 0.96; Abbreviated Injury Scale [AIS] score of 2 or higher, adjusted RR = 0.30, 95% CI = 0.16 to 0.58; ISS > 8, adjusted RR = 0.19, 95% CI = 0.06 to 0.56), and less injury in most body regions except the neck (adjusted RR = 4.79, 95% CI = 1.43 to 16.00) than did children with no restraint use. Those children who used seat belts in belt-positioning booster seats had an equal risk of injury but higher risks of neck (adjusted RR = 1.86, 95% CI = 1.02 to 3.40) and thorax (adjusted RR = 2.86, 95% CI = 1.33 to 6.15) injury than did children who were restrained by seat belts only. A higher risk of AIS > 0 injury to the neck and thorax is appeared to be experienced by children using belt-positioning booster seats than by children using seat belts only. Whether the observed increase in neck and thorax injuries can be attributed to improper use of booster seats should be examined in future research.

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  • Accession Number: 01497054
  • Record Type: Publication
  • Files: TRIS
  • Created Date: Oct 23 2013 2:13PM