Letters
Child health
Volume 189 - Issue 10

Evidence to support changes to child restraint legislation

Authors:  Wei Du, Caroline F Finch and Lynne E Bilston

Med J Aust 2008; 189 (10): 598-599. || doi: 10.5694/j.1326-5377.2008.tb02196.x
Published online: 17 November 2008
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To the Editor: Despite expert recommendation, Australian states have yet to enact legislation requiring use of child restraints beyond the age of 12 months.

Our analysis of police crash records and linked hospital separation data for the period July 2000 to June 2001 in New South Wales found that a large proportion of children who were hospitalised following motor vehicle accidents were reported by police as having used adult (standard) seatbelts at the time of injury (Box).

It is of particular concern that over 80% of 5–8-year-olds in this cohort were using standard seatbelts rather than child restraints (eg, booster seats). This pattern of premature “graduation” to seatbelts has also been reported in general populations of child motor vehicle passengers both overseas1 and in Australia,2 and also in presentations of child motor vehicle passengers after a crash to a NSW hospital’s emergency department.3

Child restraints are specifically designed to provide crash protection for children’s anthropometrical dimensions. Standard seatbelts are not designed to accommodate children, so they are unlikely to achieve the good fit to rigid body parts required for safety. Consequently, use of standard seatbelts by young children allows more head excursion during a crash, thereby negating their primary goal of protecting against central nervous system injury, and potentially causing Chance fractures and abdominal injuries.4 Our results provide further evidence that such seatbelt use may not protect, or may even cause injuries, during a crash.

Child road trauma is largely preventable or controllable with the use of appropriate child restraints, including booster seats. A cost–benefit analysis showed that the use of booster seats produced a benefit–cost ratio for road trauma prevention of 9.4 (US$1854/US$197).5 To prevent child road trauma in Australia, all child motor vehicle passengers should use appropriate child restraints.

Australian child road safety stakeholders recommend that child motor vehicle passengers use appropriate restraint systems according to their height, weight and age when travelling on road. Our findings provide further justification for proposed legislative changes that would require the compulsory use of appropriate child restraints for child motor vehicle passengers.

Child restraint use among children (0–8 years) hospitalised for injury after a motor vehicle accident, compared with that of the general population, New South Wales

Hospitalised children*

General population†

Restraint use

0–4 years

5–8 years

Total

0–4 years

5–8 years

Total

Child restraint

9 (22%)

0

9 (10%)

295 (94%)

70 (31%)

365 (68%)

Adult seatbelt

11 (27%)

42 (82%)

53 (58%)

12 (4%)

153 (67%)

165 (31%)

Unknown/ no restraint

21 (51%)

9 (18%)

30 (33%)

6 (2%)

4 (2%)

10 (2%)

Total

41 (100%)

51 (100%)

92 (100%)

313 (100%)

227 (100%)

540 (100%)

* Linked hospital and police data from July 2000 – June 2001 were accessed from the NSW Injury Risk Management Research Centre. Case selection is based on corresponding codes in the International Classification of Diseases, 10th revision, Australian modification, 2nd edition.

† Based on a telephone survey conducted in NSW during 2005–2006.

Authors

  • Wei Du1
  • Caroline F Finch2
  • Lynne E Bilston3
  • 1. NSW Injury Risk Management Research Centre, University of New South Wales, Sydney, NSW.
  • 2. University of Ballarat, Ballarat, VIC.
  • 3. Prince of Wales Medical Research Institute, University of New South Wales, Sydney, NSW.

Correspondence: w.du@unsw.edu.au

References

View this article on Wiley Online Library

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