Evid Based Nurs 3:128 doi:10.1136/ebn.3.4.128
  • Causation

Restraint use and rear seating were associated with fewer serious injuries and deaths for children in motor vehicle crashes

 QUESTION: Are restraint use and rear seating position associated with lower risks of serious injuries or death for children in motor vehicle crashes?


Cohort study.


Utah, USA.


5751 children <15 years of age who were passengers in a motor vehicle crash resulting in property damage over US$750 and fatality, admission to hospital, injuries with broken bones, or significant bleeding to any automobile occupant. Children travelling in passenger cars, light trucks, and vans were included. Children were between the ages of birth and 4 years (n=2016), 5 and 11 years (n=2231), and 12 and 14 years (n=1504).

Assessment of risk factors

For the years 1992–6, motor vehicle crash records from a statewide database, including data on age, restraint use, type of crash, and front or rear seating in the vehicle, were linked by probabilistic methods to hospital discharge records. Restraint use was classified as optimal (a safety seat for ages 0–4 y or a lap and shoulder belt for ages 5–14 y), suboptimal (a lap belt, shoulder belt, or both for ages 0–4 …

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