Citation

Woodford E, Brown J, Bilston LE. Traffic Injury Prev. 2018; 19(4): 371-377.

Affiliation

UNSW Medicine.

Copyright

(Copyright © 2018, Informa - Taylor and Francis Group)

DOI

10.1080/15389588.2017.1410545

PMID

29185794

Abstract

OBJECTIVE: Traffic crashes have high mortality and morbidity for young children. While many specialised child restraint systems improve injury outcomes, no large-scale studies have investigated the cross-chest clip's role during a crash, despite concerns in some jurisdictions about the potential for neck contact injuries from the clips. This study aimed to investigate the relationship between cross-chest clip use and injury outcomes in children between 0-4 years of age.

METHODS: Child passengers between 0-4 years of age were selected from the Crashworthiness Data System of the US National Automotive Sampling System (NASS) datasets (2003-2014). Multiple regression analysis was used to model injury outcomes while controlling for age, crash severity, crash direction and restraint type. The primary outcomes were overall Abbreviated Injury Score (AIS) 2+ injury, and the presence of any neck injury.

RESULTS: Across all children aged 0-4 years, correct chest clip use was associated with decreased AIS 2+ injury (OR 0.44, 95%CI 0.21-0.91), and was not associated with neck injury. However, outcomes varied by age. In children <12 months old, chest clip use was associated with decreased AIS 2+ injury (OR 0.09, 95%CI 0.02-0.44). Neck injury (n = 7, all AIS 1) for this age group only occurred with correct cross-chest clip use. For 1-4 year old children, cross-chest clip use had no association with AIS 2+injury, and correct use significantly decreased the odds of neck injury (OR = 0.49; 95%CI 0.27-0.87) compared to an incorrectly used or absent cross-chest clip. No serious injuries were directly caused by the chest clips.

CONCLUSIONS: Correct cross-chest clip use appeared to reduce injury in crashes, and there was no evidence of serious clip-induced injury in children in 5 point harness restraints.

Language: en

Keywords

Child restraint; injury; road trauma