Trends in booster seat use among young children in crashes

Introduction. Booster seat use in the United States is extremely low among 4- to 8-year-old children, the group targeted for their use. However, more recent attention has been paid to the role of booster seats for children wh o have outgrown their forward-facing child safety seat. In particular, seve ral states are currently considering upgrades to their child restraint laws to include the use of booster seats for children over 4 years of age. Objective. To examine recent trends in booster seat use among children invo lved in automobile crashes in 3 large regions of the United States. Design. This study was performed as part of the Partners for Child Passenge r Safety project, an ongoing, child-specific crash surveillance system that links insurance claims data to telephone survey and crash investigation da ta. All crashes occurring between December 1, 1998, and November 30, 2000, involving a child occupant between 2 to 8 years of age riding in a model ye ar 1990 or newer vehicle reported to State Farm Insurance Companies from 15 states and Washington, DC, were eligible for this study. A probability sam ple of eligible crashes was selected for a telephone survey with the driver of the vehicle using a previously validated instrument. The study sample w as weighted according to each subject's probability of selection, with anal yses conducted on the weighted sample. Results. The weighted study sample consisted of 53 834 children between 2 t o 8 years old, 11.5% of whom were using a booster seat at the time of the c rash. Booster seat use peaked at age 3 and dropped dramatically after age 4 . Over the period of study, booster seat use among 4- to 8-year-olds increa sed from 4% to 13%. Among 4-year-olds specifically, booster use increased f rom 14% to 34%. Among children using booster seats, approximately half used shield boosters and half used belt-positioning boosters. Conclusion. Although overall booster seat use among the targeted population of 4- to 8-year-old children remains low, significant increases have been noted among specific age groups of children over the past 2 years. These da ta may be useful to pediatricians, legislators, and educators in efforts to target interventions designed to increase appropriate booster seat use in these children.