Long-term effects of legislation and local promotion of child restraint use in motor vehicles in Sweden

The main objective is to study long-term effects of legislation and promoti on of child-restraint use in motor vehicles. Subgoals are to describe the l evel of restraint use in cars and changes in mortality and morbidity patter ns in regard to differences among age groups and geographical areas (morbid ity). The study areas were; `The First Four', `The Six Counties', `The Rest of Sweden', and `Sweden as a whole', and the population were two age group s - 0-6 and 7-14 years. The incidence of restraint use comes from observati ons of car-seat-belt usage. Outcome evaluation was based on hospital-discha rge data 1978-1996 and mortality statistics 1970-1996. The level of restrai nt use for children in the front seat was 97% in 1988 and was equal to 1995 . Mortality data shows a decrease of 2.8% on an average per year, 76% over the study period. A significant change over time in the two intervention ar eas was shown (annual changes of - 2.8 and - 1.8%), but not in the rest of Sweden. The local authorities that started early with preventive programs, such as safety seat loan schemes and those having an organised safety-promo tion program showed a much better improvement than the rest of Sweden. Ther e is a need for appropriate information for local action on childhood injur y prevention to accompany national legislation. (C) 2001 Elsevier Science L td. All rights reserved.