WEDNESDAY, Jan. 21 (HealthDay News) -- Placing infants and small children in age-appropriate car safety seats significantly reduces the odds that they will die if they are in a motor vehicle accident, new research shows.
Babies reaped the most benefit from being placed in a car seat. Their odds of dying in a car crash dropped by three-quarters if they were in a safety restraint seat. But older children also saw significant benefits, with a mortality risk reduction of at least 60 percent.
"The findings from this study indicate that child restraints greatly reduce the risk of death among children 3 years and younger involved in severe traffic collisions," the authors of the study wrote.
"The higher effectiveness of safety seats among infants is likely due to their overall fragility," added study author Thomas Rice, a research epidemiologist at the Traffic Safety Center in the department of environmental sciences at the University of California, Berkeley.
Results of the study appear in the February issue of the American Journal of Public Health.
Car accidents are the leading cause of unintentional injury and death for children older than 1 year, according to background information in the study. More than 500 children younger than 3 died as a result of motor vehicle collisions in 2005, according to U.S. Centers for Disease Control and Prevention statistics cited in the study.
Most states have laws requiring child safety seats in cars, and use of these devices is high for the youngest children. The National Highway Traffic Safety Administration estimated that 93 percent of babies younger than 1 year were placed in car safety seats in 2006, while 91 percent of 1- to 3-year-olds also rode in car seats, the study reported.
The study included data on child fatalities from motor vehicle collisions that occurred from 1996 to 2005. From a large initial sample of nearly 300,000 vehicles, the researchers chose 6,303 vehicles to study because of the availability of complete data on ages, positions of vehicle occupants and the type of restraints that were used (shoulder or lap seat belt, car seat, or none). They compared data from this group to a closely matched group of vehicles involved in nonfatal collisions.
The odds of a baby under 1 year of age dying in a car accident drop by 73 percent if the infant was riding in a baby car seat. For children between 1 and 2, the odds of dying in a collision went down by 76 percent if they were properly restrained. For 2 to 3 year olds, the odds of a fatality in a car crash dropped by about 60 percent if the toddler was in a car seat.
Safety seats were found to be most effective in preventing fatalities in rollover accidents, rural environments and accidents involving light trucks.
In the older age group -- children age 2 to 3 years old -- seat belts were almost as effective as car safety seats in preventing fatalities.
But, say the experts, that doesn't mean it's OK for a 2-year-old to just wear a seat belt.
"Any restraint device helps to keep the child inside the vehicle, which decreases fatalities," said Dr. Barbara Gaines, director of the Benedum Pediatric Trauma Program at Children's Hospital of Pittsburgh. "So, with the older kids, a seat belt may keep them sort of in the car, but seat belts certainly won't prevent some of the other serious injuries we see."
As Rice said, "The use of traditional seat belts for this age group is certainly not recommended, but they are far better than traveling unrestrained."
Added Gaines: "Using very robust statistical modeling, this study again proves the importance of using age-appropriate child restraints." She suggested:
- Rear-facing infant seats for up to 1 year or so
- Convertible seats for older, larger infants, until about age 3
- Booster seats for 4- to 8-year-olds
"And, check the car seat for weight guidelines, because they're not identical for all seats," Gaines said. "When children graduate from booster seats, they still need to use the car's restraints. Teenagers are the ones least likely to be restrained."
Learn more about car safety seats from the American Academy of Pediatrics.
SOURCES: Thomas Rice, Ph.D., M.P.H., research epidemiologist, Traffic Safety Center, Department of Environmental Health Sciences, University of California, Berkeley; Barbara Gaines, M.D., director, Benedum Pediatric Trauma Program, Children's Hospital of Pittsburgh; February 2009, American Journal of Public Health