麻豆传媒

NEW ORLEANS -- States that implemented booster seat laws saw a drop in serious injuries from motor vehicle crashes among children ages 4 to 8 during a recent 11-year period, researchers found.

Although the years the laws passed varied across the country, such legislation was associated with significant reductions in death or incapacitating injuries for children ages 4 to 6 (incidence rate ratio 0.82, 95% CI 0.73 to 0.91) and ages 7 to 8 (IRR 0.67, 95% CI 0.56 to 0.80), according to Lois Lee, MD, MPH, of Boston Children's Hospital.

There were no changes during the study period, however, among the three states -- Florida, Arizona, and South Dakota -- that do not have booster seat laws, she reported at the American Academy of Pediatrics meeting here. The other 47 states and the District of Columbia have all passed booster seat laws since 2001, but the ages covered varies.

"Our recommendation is that all states really should cover the optimal age, at least through 8 years old," she said in an interview with 麻豆传媒, noting that she was not aware of any movement toward federal legislation to standardize laws nationally.

Although booster seats have been shown to be effective at preventing death and serious injury from motor vehicle crashes, use remains low -- they are used by only about half of children ages 4 to 5 and 35% of those ages 6 to 7.

The AAP recommends that children should be placed in belt-positioning booster seats after the child outgrows a forward-facing car seat -- around age 4 -- and until the child attains a height of about 4'9" -- usually around age 8 to 12. The height requirement is to ensure that the vehicle's lap-and-shoulder seat belts fit properly.

To examine the effect of booster seat laws on the national scale, Lee and colleagues looked at data from the Fatality Analytic Reporting System to identify crash-related fatalities and incapacitating injuries that occurred among children ages 4 to 8 from 1999 through 2009.

There were 9,848 deaths or incapacitating injuries during the study period, and the rate was lower following passage of booster seat laws for children ages 4 to 8 after adjustment for state highway speed limit, blood alcohol limit, adult fatality and injury rates, and median income.

The researchers then looked at the association between proper use of booster seats and serious injuries.

Compared with being restrained properly in a booster seat, using the lap and/or shoulder belt only was associated with a greater likelihood of death or incapacitating injury in children ages 4 to 6 (OR 1.2, 95% CI 1.1 to 1.3) and ages 7 to 8 (OR 1.7, 95% CI 1.2 to 2.4).

Not using a restraint at all, being improperly restrained, or having an unknown restraint status also was associated with increased odds of death or incapacitating injury in children ages 4 to 6 (OR 2.0, 95% CI 1.8 to 2.1) and ages 7 to 8 (OR 4.2, 95% CI 3.0 to 5.8).

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