research >> Child Passenger and child pedestrian Safety (see also seatbelt use)

Child Restraint Systems (links to another page)

Back-Over Injuries Among Children

Every year in the U.S., hundreds of children are killed or injured by vehicles in driveways or parking areas. These are often young children who are playing at or near their home; the drivers are often family members. Little is known about the risk factors for these events, and incidence is difficult to estimate because case ascertainment using police collision reports is incomplete.

Methods: Eight California trauma centers conducted surveillance of pediatric back-over and front-over injury from January 2005 to July 2007. Identified patients and families at each facility were invited to participate in an interview to identify circumstances of the incident.

Results: A total of 93 incidents were identified. Nine (10%) were fatal. Sixty-nine (74%) of the patients were four years old or younger. Twenty-one (23%) families agreed to participate in an interview.

Of the 21 victims whose families were interviewed, 17 (81%) were male and the median age was 28 months. In 13 (62%) cases, the child was backed over, and in 11 (52%) cases, the driver was the mother or father. Fifteen (71%) cases involved a sports utility vehicle, pick-up truck, or van. Most of these incidents occurred in a residential driveway. Average length of stay in the hospital was 2.9 days.

Conclusion: Surveillance of back-over injury using police and EMS data is needed to enhance our understanding of this problem and to inform prevention efforts. Case-control studies of risk factors are needed to clarify causal factors and to identify modifiable risk factors.

Seat Belt, Child Safety Seat and Bicycle Helmet Survey Methodology Development Project

The TSC developed protocols for conducting roadside observational surveys of child safety seat, seat belt, and bicycle helmet use. The TSC developed workbooks and guidelines for conducting surveys, which are posted on the Web site of the Office of Traffic Safety (OTS), which funded the work.

California Child Passenger Safety Initiative (CPSI)

CPSI was launched in 2002 for 18 months to increase knowledge of and compliance with the then-new California child passenger safety seat law. It was intended to increase the use (and decrease the misuse) of child restraint systems among the most vulnerable children in California, i.e., children of color and children living in poverty. The CPSI targeted families who use public medical services at selected sites. The TSC conducted various studies:

A pre-intervention baseline study found that only about 80% of participants report that they always use a CPS system, more than 30% of children are not placed in restraints appropriate for their age and weight, and that many children are improperly fastened or the systems are improperly fastened to the vehicle.

An evaluation compared pre- and post-intervention data for families with children age six and younger. Although the results of this study were mixed, dramatic increases in the use of certain child restraints and decreases in the misuse of others were observed.

SafeTREC Resources

Inclusion of adult vehicle occupants in matched-cohort studies of child restraint effectiveness.
APAH 2010 Poster by Thomas M. Rice, MPH, PhD , Department of Environmental Health Services, SafeTREC, University of California, Berkeley, Berkeley, CA, and Craig L. Anderson, DHSc, PhD , Department of Emergency Medicine, University of California Irvine, Orange, CA

Evaluation of the California Child Passenger Safety Initiative
Jill F. Cooper, Kara E. MacLeod, David R. Ragland. TSC Research Report. (2004)

Keeping Children Safe in Cars
Jill F. Cooper. ACCESS magazine, Number 24, Spring 2004.

"Evaluation of the California Child Passenger Safety Initiative."
David R. Ragland, Jill F. Cooper, Kara E. MacLeod. Presented at the Transportation Research Board Annual Meeting. January 2005. Requires PowerPoint™ to view.

"Child passenger safety evaluation: A public hospital-based research project" Jill F. Cooper, Kara E. MacLeod, David R. Ragland. (2003). Paper.

"Making Child Safety Seats Part of a Prescription for Good Health" TSC Online Newsletter. December 2002.

"The 'Forgotten Child' Is Getting Some Attention at Last: Booster seats now the law in some states." TSC Online Newsletter. December 2002.

California Child Restraint Law (PDF). Posted 2002.

Pre-Intervention Assessment: UC Davis Medical Center and California Health Care Safety Net Institute Child Passenger Safety Initiative
Jill F. Cooper, Kara E. MacLeod, David R. Ragland, TSC, Wendy Jameson, California Health Care Safety Net Institute. TSC Research Report. (2002)