Rear-Facing Child Car Seats: Are Laws Requiring Them Effective?

Introduction: Motor vehicle crashes are a leading cause of death in children aged ≤ 2 years in the U.S. The American Academy of Pediatrics advised that children should remain in rear-facing child car seats to mitigate injury from the most common type of severe collision (frontal). Several states have passed laws following these recommendations. Methods: In 2013 publicly available statutes and comprehensive motor vehicle fatality data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System database were used to investigate whether there is a relationship between motor vehicle crash fatality rates for children under 1 year of age and state laws regulating the direction of car seat placement. States with known rear-facing car seat laws in place were analyzed in a two-step approach in 2014. Simple fatality rates per 100 million vehicle miles were calculated with 95% Poisson CIs. A negative binomial count model for infant deaths was calculated, with state fixed effects, adjusted for the exposure of vehicle miles in each state by year. Results: Unadjusted models showed a protective mortality effect for rear-facing car seat laws, while adjusted models demonstrated no beneficial effect.Implications: This preliminary study suggests that state rear-facing child restraint laws may be having an impact on infant motor vehicle mortality; however the current model is unable to determine their relative contribution given the overall decline in traffic mortality.

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  • Supplemental Notes:
    • © 2016 Eli Friedman et al.
  • Authors:
    • Friedman, Eli
    • Carretta, Henry J
    • Jordan, Joshua
    • Beitsch, Leslie M
  • Publication Date: 2015-3


  • English

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  • Accession Number: 01602129
  • Record Type: Publication
  • Files: TRIS
  • Created Date: Jun 3 2016 9:28AM