Child restraint use is higher than ever, according to a report released Sept. 22 by the Children's Hospital of Philadelphia and the Association for International Automobile Manufacturers. Over an eight-year period, from 1999 to 2007, researchers noted that overall child restraint use increased from 51 percent to 80 percent among children younger than 9. During this same period, age-appropriate restraint use, including booster seats, among 4- to 8-year-olds quadrupled, from 15 percent appropriately restrained in 1999 to 63 percent in 2007.

These statistics are included in the 2008 “Partners for Child Passenger Safety (PCPS) Fact and Trend Report,” a snapshot of the milestones reached over a decade of research tracking children involved in real-world motor vehicle crashes. The report assesses data from the world's largest study of children in automobile crashes based on cases identified from State Farm Insurance companies from 1998 until 2007. Taking the long view, researchers can identify the protective benefits of improved technologies, legislation, and education over time, and they also can point out where improvements are still needed. The 2008 report, released in time for National Child Passenger Safety Week (September 21-26), is available for download from www.chop.edu/carseat.

"Over the past decade, we have seen booster seat use among 4- and 5-year-olds increase from 30 percent to 88 percent; and among 6-, 7-, and 8- year-olds, booster use increased from just 2 percent in 1999 to 43 percent in 2007," says Kristy Arbogast, Ph.D., director of engineering at CHOP's Center for Injury Research and Prevention, where the long-term study was conducted. "Along with the increase we see in the number of kids riding in child restraints, we can also see changes in the types of restraints they are using now versus ten years ago. More 4- and 5-year-olds are riding in booster seats now, rather than in car seats with built-in harnesses, with slightly more of them in high back booster seats than backless; but among the 6- through 8-year-olds, backless booster seats are far more prevalent than high back booster seats."

Previous research from the PCPS study shows that for 4- to 8-year-olds, booster seat use reduces the risk of injury in a crash by 59 percent. Booster seats elevate children's small bodies to ensure proper seat belt fit, better protecting them in case of a crash. Further research from the same research project found that 6- to 8-year-olds in states with booster seat laws were twice as likely to be in child restraints as children of the same age in states without those laws.

"Enactment and promotion of state laws requiring booster seats for older children and consistent education efforts about age appropriate restraint use are paying off," explains Arbogast. "More parents than ever now realize that kids need the help of a booster seat to make sure the belt fits properly across the bony parts of their lap and shoulder, rather than across the soft belly or the neck, which are more prone to injury." Typically the adult seat belt begins to fit properly for children at about 4 feet 9 inches tall, usually around age 8.

To help parents seeking more information about booster seats, CHOP offers easy-to-follow tips and brief videos on their "Keeping Kids Safe in Crashes" website for parents, www.chop.edu/carseat.

"The ‘PCPS Fact and Trend Report’ serves as a reminder that we need to continue taking steps to ensure all children are protected on the road," said Michael J. Stanton, president and CEO of AIAM. "We are honored to provide our support for this critical report. Child safety is a top priority for our member companies, and the Children's Hospital of Philadelphia has a long history of leadership on such an important issue."

Additional findings from the 2008 “PCPS Fact and Trend Report”:

• Child restraint use - 1999 vs. 2007: Overall, Americans have significantly improved child restraint use among children younger than 8, from 51 percent in 1999 to 80 percent in 2007.
• Distance: The majority (60 percent) of crashes involving children occur within 10 minutes of home; 84 percent take place within 20 minutes of home.
• Booster seat law success: States with comprehensive booster seat laws (covering children up to age 8) reported the most progress in increasing child restraint use through 8 years of age. The states with the lowest rate of booster seat use among 4- to 8-year-olds do not have booster seat laws.
• State-by-state success: Of the 16 states included in the PCPS study, Pennsylvania recorded the highest rate of booster seat use among 4- to 8-year-olds (72 percent).
• Children in front seat: Although the American Academy of Pediatrics recommends all children younger than 13 sit in the rear seat, approximately one-third of 8- to 12-year-olds still ride in the front seat.
• Injuries by age group: As children age, their risk of injury in a crash rise, as 13- to 15- year-olds are at the highest risk for injury in a crash. Head injuries are the most common type for all age groups.
• Age of driver: Children have a much higher risk of injury when the driver is younger than age 20. Although only 4.2 percent of crashes involve a driver aged 16 to 19, child passengers in these crashes are nearly four times as likely to be injured.
• Speed limits: Vehicle crashes with the highest number of significant injuries occur on roads with posted speed limits of 45 to 64 mph.

Source: The Center for Injury Research and Prevention, Association of International Automobile Manufacturers

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