Predictors of hazardous child seating behavior in fatal motor vehicle crashes: 1990 to 1998

Objective. Motor vehicle crashes are the leading cause of death in children ages 5 to 14. Children seated in the front seats of vehicles are at increa sed risk of death and injury in crashes, particularly in vehicles with pass enger-side air bags. This study identifies factors associated with the seat ing of children in the front seats of vehicles involved in fatal crashes be tween 1990 and 1998. Methods. Using 1990 to 1998 data from the Fatal Analysis Reporting System, a US census of motor vehicle crashes involving a fatality, multivariable lo gistic regression was used to model the association between child seating b ehavior and vehicle, driver, and occupant characteristics. Results. The proportion of vehicles carrying children in the front declined from 42% to 31% over the 9-year period. Controlling for driver and vehicle characteristics, the risk of front-seating declined between 1990 and 1998, and this risk was smaller in vehicles carrying only younger children (less than or equal to6 years) than in those carrying older children. In the 3 y ears after the introduction of dual air bags into a significant proportion of the passenger fleet in late 1995, dual air bags were associated with few er children being seated in the front seat. By the end of 1998, traveling i n a vehicle with dual air bags and only children age 6 or younger was assoc iated with a 95% lower chance of a child being seated in the front (odds ra tio = 0.05; 95% confidence interval: 0.04-0.08). An important factor in saf er seating position was the presence of multiple passengers, especially an older one, and children were at higher risk of front-seating when they trav eled alone with the driver. Conclusions. The 1990s saw a decline in front-seating of children in vehicl es involved in fatal crashes among all types of vehicles and drivers. Altho ugh this trend is encouraging, children ages 6 to 12 and children traveling alone with the driver remain at higher risk of being seated in the front. These traveling situations should be targeted for behavioral safety interve ntions to improve child motor vehicle safety.